NPIMap

Organization Active NPI

Skull Valley Health Clinic

  • Clinic/Center
  • Tooele, UT
National Provider Identifier
1710468384
Registry record updated Aug 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
SKULL VALLEY HEALTH CLINIC
Practice address
1929 Aaron Dr Ste I
Tooele, UT 84074-8112
Phone
(801) 631-8362
NPI assigned
Aug 22, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2018

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

Authorized official

Name
Lance Johnson
Title
Administrator
Phone
(801) 631-8362

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

1929 Aaron Dr Ste I
Tooele, UT 84074-8112

Mailing address

1929 Aaron Dr Ste I
Tooele, UT 84074-8112
Phone (801) 631-8362

National Provider Directory

National Provider Directory
Tax ID family
Warrior Spirit Recovery Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1534896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534896000000",
    "number": "1710468384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1929 AARON DR STE I",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "840748112",
            "telephone_number": "801-631-8362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1929 AARON DR STE I",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "840748112",
            "telephone_number": "801-631-8362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKULL VALLEY HEALTH CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-22",
        "last_updated": "2018-08-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "LANCE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "801-631-8362"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tooele, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2018; 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.