Ikae, Inc

Key facts

NPI

1659535243

Entity type

Organization (NPI type 2)

Primary specialty

Community/Behavioral Health Agency 251S00000X

License

52521653501 (UT)

Legal business name

IKAE, INC

Practice address

640 E 700 S
Suite 207
Saint George, UT 84770-4023

Phone

(435) 628-2718

NPI assigned

Jul 14, 2008

Organization subpart

No

Authorized official

Name

Iuri Tiago Melo, LCSW

Title

Owner

Phone

(435) 986-1805

National Provider Directory

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 14, 2008.

{
    "created_epoch": "1215993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215993600000",
    "number": "1659535243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "689 E SONORAN DR",
            "city": "WASHINGTON",
            "state": "UT",
            "postal_code": "847808261",
            "telephone_number": "435-986-1805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 E 700 S",
            "address_2": "SUITE 207",
            "city": "SAINT GEORGE",
            "state": "UT",
            "postal_code": "847704023",
            "telephone_number": "435-628-2718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IKAE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-14",
        "last_updated": "2008-07-14",
        "status": "A",
        "authorized_official_last_name": "MELO",
        "authorized_official_first_name": "IURI",
        "authorized_official_middle_name": "TIAGO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "435-986-1805",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "UT",
            "license": "52521653501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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