Utah Independent Living Center, Inc.

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

License

0176 Issued in UT

Legal business name

UTAH INDEPENDENT LIVING CENTER, INC.

Practice address

3445 S Main St
Salt Lake City, UT 84115-4418

Phone

(801) 466-5565

Fax

(801) 466-2363

NPI assigned

Jan 3, 2007

Last updated

Aug 22, 2020By 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

Ms. Debra A, Mair

Title

Executive Director

Phone

(801) 466-5565

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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.

• Tonya Segura Makoff

  • Case Manager/Care Coordinator
  • South Salt Lake, UT
  • NPI 1336097351
  NPD (past)

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841347036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3445 S MAIN ST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841154418",
            "telephone_number": "801-466-5565",
            "fax_number": "801-466-2363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3445 S MAIN ST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841154418",
            "telephone_number": "801-466-5565",
            "fax_number": "801-466-2363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UTAH INDEPENDENT LIVING CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MAIR",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "A,",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "801-466-5565",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "UT",
            "license": "0176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SERVICING AND LICENCE NUM",
            "identifier": "0176",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Utah Gastroenterology LLC
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• Utah House
• Utah Imaging Associates
• Utah Infertility Resource Center
• Utah Injury Clinic, LLC
• Utah Luna Care Physical Therapy LLC
• Utah Medical Specialists PC
• Utah Neuropsychiatric Institute

• Case Management Agency in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Case Management Agency in Utah

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