NPIMap

Organization Active NPI

Intermountain Specialized Abuse Treatment Center

  • Community/Behavioral Health Agency
  • Provo, UT
National Provider Identifier
1962733931
Registry record updated Jan 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
6615379-3501 Issued in UT
Legal business name
INTERMOUNTAIN SPECIALIZED ABUSE TREATMENT CENTER
Practice address
1868 N 1120 W
Provo, UT 84604-1179
Phone
(801) 373-0210
Fax
(801) 373-0215
NPI assigned
Jan 14, 2010
Last updated
Jan 14, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2010

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

Authorized official

Name
Mr. Christopher David Westover, LCSW
Title
Clinical Director
Phone
(801) 373-0210

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 6615379-3501 UT Primary

Addresses

Primary practice location

1868 N 1120 W
Provo, UT 84604-1179

Mailing address

1868 N 1120 W
Provo, UT 84604-1179
Phone (801) 373-0210

National Provider Directory

National Provider Directory
Tax ID family
Intermountain Specialized Abuse Treatment Center Isat4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

1868 N 1120 W
Provo, UT 84604
Phone (801) 373-0210

NPI Registry JSON

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

{
    "created_epoch": "1263427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263427200000",
    "number": "1962733931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1868 N 1120 W",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846041179",
            "telephone_number": "801-373-0210",
            "fax_number": "801-373-0215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1868 N 1120 W",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846041179",
            "telephone_number": "801-373-0210",
            "fax_number": "801-373-0215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERMOUNTAIN SPECIALIZED ABUSE TREATMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-14",
        "last_updated": "2010-01-14",
        "status": "A",
        "authorized_official_last_name": "WESTOVER",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "801-373-0210",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "UT",
            "license": "6615379-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2010; 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.