Alta Summit, Inc.

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

ALTA SUMMIT, INC.

Practice address

3855 S 500 W Ste H
South Salt Lake, UT 84115-4253

Phone

(801) 281-0700

NPI assigned

May 26, 2022

Last updated

Jun 2, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dan Fazzini Jr.

Title

Trustee

Phone

(801) 281-0700

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1653523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654128000000",
    "number": "1699413849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3855 S 500 W STE E",
            "city": "SOUTH SALT LAKE",
            "state": "UT",
            "postal_code": "841154253",
            "telephone_number": "801-281-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3855 S 500 W STE H",
            "city": "SOUTH SALT LAKE",
            "state": "UT",
            "postal_code": "841154253",
            "telephone_number": "801-281-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALTA SUMMIT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-26",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A",
        "authorized_official_last_name": "FAZZINI",
        "authorized_official_first_name": "DAN",
        "authorized_official_title_or_position": "TRUSTEE",
        "authorized_official_telephone_number": "801-281-0700",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Substance Use Disorder Rehabilitation Clinic/Center in South Salt Lake, UT
• Providers in South Salt Lake, UT by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2022; 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.