WASATCH YOUTH SUPPORT SYSTEMS NPI 1790088011

NPI Information

NPI: 1790088011
Provider Name: WASATCH YOUTH SUPPORT SYSTEMS
Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

Address:
3392 W 3500 S
WEST VALLEY CITY, UT
ZIP 84119
Phone: (801) 969-3307
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WASATCH YOUTH SUPPORT SYSTEMS is a rehabilitation and substance use disorder clinic center in West Valley City, UT. WASATCH YOUTH SUPPORT SYSTEMS NPI is 1790088011. The provider is registered as an organization entity type.

The provider's business location address is:

3392 W 3500 S
WEST VALLEY CITY, UT
ZIP 84119-630
Phone: (801) 969-3307
Fax: (801) 964-8988

The provider's authorized official is James Russell Marchell .
The authorized official title is Agencey Administrator and has the following contact phone number (801) 969-3307.

The enumeration date for this NPI number is 12/8/2010 and was last updated on 12/8/2010.

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	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder	293074-3501	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	261QR0405X	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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