NPIMap

Organization Active NPI

State of Utah, Department of Health

Doing business as San Juan Baby Watch Early Intervention

  • Early Intervention Provider Agency
  • Salt Lake City, UT
National Provider Identifier
1811504483
Registry record updated Sep 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Legal business name
STATE OF UTAH, DEPARTMENT OF HEALTH
Doing business as
San Juan Baby Watch Early Intervention
Practice address
288 N 1460 W
Salt Lake City, UT 84116-3231
Phone
(801) 273-2900
NPI assigned
Sep 28, 2020
Last updated
Sep 28, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2020

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

Authorized official

Name
Mykio Saracino, MPA
Title
Financial Manager
Phone
(385) 228-4798

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X Primary

Addresses

Primary practice location

288 N 1460 W
Salt Lake City, UT 84116-3231

Mailing address

PO Box 144720
Salt Lake City, UT 84114-4720
Phone (801) 273-2900

Other names 1

  • San Juan Baby Watch Early Intervention Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Utah's Children's Justice Center Program28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

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

View all 27

Locations

288 N 1460 W
Salt Lake Cty, UT 84116
Phone (801) 538-6122

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1601251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601251200000",
    "number": "1811504483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 144720",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841144720",
            "telephone_number": "801-273-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "288 N 1460 W",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841163231",
            "telephone_number": "801-273-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF UTAH, DEPARTMENT OF HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-28",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A",
        "authorized_official_last_name": "SARACINO",
        "authorized_official_first_name": "MYKIO",
        "authorized_official_title_or_position": "FINANCIAL MANAGER",
        "authorized_official_telephone_number": "385-228-4798",
        "authorized_official_credential": "MPA"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Juan Baby Watch Early Intervention",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Sep 28, 2020; 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.