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PROVIDENTIAL BBA OPERATING LP NPI 1275560062


NPI Information

NPI: 1275560062
Provider Name: PROVIDENTIAL BBA OPERATING LP

Doing Business As: SOUTH DAVIS HOME HEALTH

Classification: Home Health - 251E00000X
Entity Type: Organization
Address:
401 S 400 E
BOUNTIFUL, UT
ZIP 84010
Phone: (801) 295-2361
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PROVIDENTIAL BBA OPERATING LP is a home health in Bountiful, UT. The provider is a public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. PROVIDENTIAL BBA OPERATING LP NPI is 1275560062. The provider is registered as an organization entity type.
The provider Is Doing Business As South Davis Home Health.

The provider's business location address is:

401 S 400 E
BOUNTIFUL, UT
ZIP 84010-933
Phone: (801) 295-2361
Fax: (801) 295-1398

The provider's authorized official is Michelle Brown .
The authorized official title is Cfo and has the following contact phone number (801) 397-8145.

The enumeration date for this NPI number is 6/27/2006 and was last updated on 7/15/2020.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251E00000XHome Health2006HHA649UTAHYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11275560062MEDICAIDUTAH

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

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