WEST JORDAN CARE CENTER NPI 1871570374

NPI Information

NPI: 1871570374
Provider Name: WEST JORDAN CARE CENTER
Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
Entity Type: Organization
Address:
3350 W 7800 S
WEST JORDAN, UT
ZIP 84088
Phone: (801) 282-0686
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WEST JORDAN CARE CENTER is an intermediate care facility mentally retarded in West Jordan, UT. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. WEST JORDAN CARE CENTER NPI is 1871570374. The provider is registered as an organization entity type.

The provider's business location address is:

3350 W 7800 S
WEST JORDAN, UT
ZIP 84088-506
Phone: (801) 282-0686
Fax: (801) 282-9767

The provider's authorized official is Gary M. Kelso .
The authorized official title is President and has the following contact phone number (801) 389-1523.

The enumeration date for this NPI number is 12/27/2005 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	315P00000X	Intermediate Care Facility, Intellectual Disabilities		2004-NCF-470	UTAH	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	742561471031	MEDICAID	UTAH

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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