NPIMap

Organization Active NPI

Salt Lake County Youth Services

  • Mental Illness Community Based Residential Treatment Facility
  • Salt Lake City, UT
National Provider Identifier
1639589344
Registry record updated May 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
1558665026 Issued in UT
Legal business name
SALT LAKE COUNTY YOUTH SERVICES
Practice address
177 W Price Ave
Salt Lake City, UT 84115-4345
Phone
(385) 468-4500
Fax
(385) 468-4461
NPI assigned
May 2, 2014
Last updated
May 2, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Debbie Osborne
Title
Counseling Services Coordinator
Phone
(385) 468-4519

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X 1558665026 UT Primary

Addresses

Primary practice location

177 W Price Ave
Salt Lake City, UT 84115-4345

Mailing address

177 W Price Ave
Salt Lake City, UT 84115-4345
Phone (385) 468-4500

Other identifiers 1

IdentifierTypeStateIssuer
1558665026MedicaidUT

National Provider Directory

National Provider Directory
Tax ID family
S L Mental Heath12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Locations

177 W Price Ave
South Salt Lake, UT 84115
Phone (385) 468-4500

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1398988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398988800000",
    "number": "1639589344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "177 W PRICE AVE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841154345",
            "telephone_number": "385-468-4500",
            "fax_number": "385-468-4461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 W PRICE AVE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841154345",
            "telephone_number": "385-468-4500",
            "fax_number": "385-468-4461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALT LAKE COUNTY YOUTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-02",
        "last_updated": "2014-05-02",
        "status": "A",
        "authorized_official_last_name": "OSBORNE",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "COUNSELING SERVICES COORDINATOR",
        "authorized_official_telephone_number": "385-468-4519"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "UT",
            "license": "1558665026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1558665026",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.