<Unavail>
LBN: Evolution Academy Of Utah Llc
<Unavail> is an health care organization with primary practice located at 1144 W 3300 S , Salt Lake City UT 84119-7175. The organization recently has only one registered license in Residential Treatment Facilities / Psychiatric Residential Treatment Facility, which is considered as the primary health care specialty.
Evolution Academy Of Utah Llc can be contacted via phone (801) 433-2900, or through Bailey, James via phone (801) 433-2900.
Contact Information
Primary practice address
1144 W 3300 S
Salt Lake City UT 84119-7175
Phone: (801) 433-2900
Fax: (801) 433-2999
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Residential Treatment Facilities / Psychiatric Residential Treatment Facility | 323P00000X | 11353 | Utah |
Profile Details
| NPI number | 1558432849 |
|---|---|
| LBN Legal business name | Evolution Academy Of Utah Llc |
| DBA Doing business as | <Unavail> |
| Authorized official | Bailey, James |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Nov 10th, 2006 |
| Last updated | Aug 22nd, 2020 - about 6 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1558432849 | NPPES |
| South Dakota | MEDICAID | 5168120 | |
| South Dakota | MEDICAID | 4103783 | |
| South Dakota | MEDICAID | HS339PI | |
| South Dakota | MEDICAID | 3810005990 | |
| South Dakota | MEDICAID | 4766 | |
| South Dakota | MEDICAID | 55880347 |
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