NPIMap

Organization Active NPI

State of Utah

Doing business as Juvenile Justice and Youth Services

  • Prison Health Clinic/Center
  • SLC, UT
National Provider Identifier
1982429528
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prison Health Clinic/CenterTaxonomy code 261QP2400X
Legal business name
STATE OF UTAH
Doing business as
Juvenile Justice and Youth Services
Practice address
195 N 1950 W
SLC, UT 84116-3100
Phone
(801) 538-4330
NPI assigned
Nov 19, 2024
Last updated
Nov 19, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
STATE OF UTAHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Authorized official

Name
Brett Petersen
Title
Division Director
Phone
(801) 538-4330

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prison Health Clinic/Center 261QP2400X NU Primary

Addresses

Primary practice location

195 N 1950 W
SLC, UT 84116-3100

Mailing address

195 N 1950 W
SLC, UT 84116-3100

Other names 1

  • Juvenile Justice and Youth Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Utah Department of Heal28 organizations share this tax ID, including this one
Part of
Utah Department of Heal

Other organizations with this tax ID 27

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

View all 27

Locations

195 N 1950 W
Slc, UT 84116
Phone (801) 538-4001

NPI Registry JSON

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

{
    "created_epoch": "1731974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731974400000",
    "number": "1982429528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 N 1950 W",
            "city": "SLC",
            "state": "UT",
            "postal_code": "841163100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 N 1950 W",
            "city": "SLC",
            "state": "UT",
            "postal_code": "841163100",
            "telephone_number": "801-538-4330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF UTAH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STATE OF UTAH",
        "enumeration_date": "2024-11-19",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "DIVISION DIRECTOR",
        "authorized_official_telephone_number": "801-538-4330"
    },
    "taxonomies": [
        {
            "code": "261QP2400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Prison Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Juvenile Justice and Youth Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in SLC, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; 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.