NPIMap

Organization Active NPI

Odyssey House of Utah

  • Community/Behavioral Health Agency
  • Salt Lake City, UT
National Provider Identifier
1992148779
Registry record updated Apr 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
ODYSSEY HOUSE OF UTAH
Practice address
350 E 2100 S
Salt Lake City, UT 84115-2266
Phone
(801) 428-3241
Fax
(801) 322-4002
NPI assigned
Apr 11, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2013

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

Authorized official

Name
Dr. Berrett Bonnella, PHD
Title
LCSW/Intern Supervisor
Phone
(801) 428-3241

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

350 E 2100 S
Salt Lake City, UT 84115-2266

Mailing address

350 E 2100 S
Salt Lake City, UT 84115-2266
Phone (801) 428-3241

National Provider Directory

National Provider Directory
Tax ID family
Odyssey House Inc14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

Locations

350 E 2100 S
South Salt Lake, UT 84115
Phone (801) 322-1185

NPI Registry JSON

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

{
    "created_epoch": "1365638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365638400000",
    "number": "1992148779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 E 2100 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841152266",
            "telephone_number": "801-428-3241",
            "fax_number": "801-322-4002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 E 2100 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841152266",
            "telephone_number": "801-428-3241",
            "fax_number": "801-322-4002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ODYSSEY HOUSE OF UTAH",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-11",
        "last_updated": "2013-04-11",
        "status": "A",
        "authorized_official_last_name": "BONNELLA",
        "authorized_official_first_name": "BERRETT",
        "authorized_official_title_or_position": "LCSW/INTERN SUPERVISOR",
        "authorized_official_telephone_number": "801-428-3241",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2013; 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.