Black Shirt Services

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

102119070160 Issued in UT

Legal business name

BLACK SHIRT SERVICES

Practice address

513 S 3040 W
Lehi, UT 84043-5636

Phone

(385) 539-0035

Fax

(385) 448-5123

NPI assigned

Feb 7, 2017

Organization subpart

No

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

Authorized official

Name

Jason Hoke

Title

Executive Director

Phone

(385) 539-0035

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1486425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486425600000",
    "number": "1942748249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1008",
            "city": "LEHI",
            "state": "UT",
            "postal_code": "840437008",
            "telephone_number": "385-539-0035",
            "fax_number": "385-448-5123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 S 3040 W",
            "city": "LEHI",
            "state": "UT",
            "postal_code": "840435636",
            "telephone_number": "385-539-0035",
            "fax_number": "385-448-5123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACK SHIRT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-07",
        "last_updated": "2017-02-07",
        "status": "A",
        "authorized_official_last_name": "HOKE",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "385-539-0035"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "UT",
            "license": "102119070160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Logan Douglas Birch, DPM
• Jordan Hadley Bird
• Birthing Your Way
• Birthing Your Way, LLC
• Brindie Allan Bishop, CPM
• Nathan Black, LCSW
• Spencer Evan Black, MD
• Timothy Jared Black
• Steven Phillips Blackhurst, DDS
• Faith Blair, CSW

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Lehi, UT
• Providers in Lehi, UT by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2017; 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.