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SUMMIT COUNTY CLUBHOUSE NPI 1902456148


NPI Information

NPI: 1902456148
Provider Name: SUMMIT COUNTY CLUBHOUSE
Classification: Case Manager/Care Coordinator - 171M00000X
Entity Type: Organization

CLIA Number: 46D0705763

Address:
1283 DEER VALLEY DR
PARK CITY, UT
ZIP 84060
Phone: (801) 930-0277
Get Directions

SUMMIT COUNTY CLUBHOUSE is a case manager care coordinator in Park City, UT. The provider is a person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee's progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. SUMMIT COUNTY CLUBHOUSE NPI is 1902456148. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1283 DEER VALLEY DR
PARK CITY, UT
ZIP 84060-182
Phone: (801) 930-0277

The provider's authorized official is Amber Mackay .
The authorized official title is Executive Director and has the following contact phone number (801) 930-0277.

The CLIA number assigned to this NPI record is 46D0705763 - other - county health department with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 9/19/2019 and was last updated on 11/27/2023.


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
1101YM0800XCounselorMental HealthNo
2171M00000XCase Manager/Care CoordinatorYes

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
11003101MEDICAIDUTAH

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.