Johanna Care Center, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

2006-NCF-58 Issued in UT

Legal business name

JOHANNA CARE CENTER, INC.

Practice address

433 E 2700 S
S Salt Lake, UT 84115-3325

Phone

(801) 487-2248

Fax

(801) 746-8554

NPI assigned

Sep 13, 2006

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

Mr. Walter Matjasich

Title

Administrator

Phone

(801) 487-2248

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1932204492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433 E 2700 S",
            "city": "S SALT LAKE",
            "state": "UT",
            "postal_code": "841153325",
            "telephone_number": "801-487-2248",
            "fax_number": "801-746-8554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 E 2700 S",
            "city": "S SALT LAKE",
            "state": "UT",
            "postal_code": "841153325",
            "telephone_number": "801-487-2248",
            "fax_number": "801-746-8554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHANNA CARE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MATJASICH",
        "authorized_official_first_name": "WALTER",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "801-487-2248",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "UT",
            "license": "2006-NCF-58",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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.