Organization · Type 2 NPI

Subtenant 1430 East 4500 South LLC

Psychiatric Hospital · Salt Lake City, UT

NPI number 1629129689 Active

Practice location

1430 East 4500 South
Salt Lake City, UT 84117-4208

Call (801) 272-8000 Map

Fax (801) 272-4983

Mailing address

6400 Oak Canyon, 200
Irvine, CA 92618-5233

Specialties and licenses

TaxonomyCodeLicense
Psychiatric Hospital Primary 283Q00000X2011-HOSP-100053 (UT)
Skilled Nursing Facility 314000000XNone listed

Psychiatric Hospital: An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings.

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About NPI 1629129689

Subtenant 1430 East 4500 South LLC's National Provider Identifier is 1629129689, issued on Jan 16, 2007. The primary taxonomy on file is Psychiatric Hospital (283Q00000X), and the practice location is in Salt Lake City, UT. The record was last updated on Jul 26, 2016.