ERIC PETER RYDZEWSKI (NPI# 1083073985) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083073985 |
| Entity Type | Individual |
| Full Name | ERIC PETER RYDZEWSKI |
| Practice Address |
344 E 100 S Suite 301 Salt Lake City UT 84111-1700 |
| Mailing Address |
1726 E Blaine Ave Salt Lake City UT 84108-2904 |
| Practice Telephone | 8013224257 |
| Mailing Telephone | 5707807703 |
| Enumeration Date | 2016-02-19 |
| Last Update Date | 2016-02-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3245S0500X |
Substance Abuse Rehabilitation Facility Specialization: Substance Abuse Treatment, Children |
Residential Treatment Facilities |
| Street Address |
344 E 100 S SUITE 301 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84111-1700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033710702 | Alyssa Nikole Tisdale | Case Manager/Care Coordinator | 344 E 100 S, Salt Lake City, UT 84111-1700 | 2020-11-07 |
| 1275134074 | Tina Floyd | Case Manager/Care Coordinator | 344 E 100 S, Salt Lake City, UT 84111-1700 | 2020-11-06 |
| 1568063360 | Sylvia Anna Malinowski | Case Manager/Care Coordinator | 344 E 100 S, Salt Lake City, UT 84111-1700 | 2020-11-06 |
| 1346841392 | Kasia Fackrell | Case Manager/Care Coordinator | 344 E 100 S, Salt Lake City, UT 84111-1700 | 2020-11-05 |
| 1770184756 | Shayla Dawn Dinger | Case Manager/Care Coordinator | 344 E 100 S, Salt Lake City, UT 84111-1700 | 2020-11-05 |
| 1275134405 | Alicia Beth Zollinger | Case Manager/Care Coordinator | 344 E 100 S, Salt Lake City, UT 84111-1700 | 2020-11-04 |
| 1366043499 | Alyssa Butler | Case Manager/Care Coordinator | 344 E 100 S, Salt Lake City, UT 84111-1700 | 2020-11-04 |
| 1518568823 | Makinley Herrera | Case Manager/Care Coordinator | 344 E 100 S, Salt Lake City, UT 84111-1700 | 2020-11-03 |
| 1851992119 | Brooke Butcher | Case Manager/Care Coordinator | 344 E 100 S, Salt Lake City, UT 84111-1700 | 2020-11-03 |
| 1063012003 | Jasmine Jemima Miyako Garcia | Case Manager/Care Coordinator | 344 E 100 S, Salt Lake City, UT 84111-1700 | 2020-10-29 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316551336 | Mary Ann Rush | Case Manager/Care Coordinator | 334 E. 100 S., Slc, UT 84111 | 2020-09-08 |
| 1790396554 | Stephanie G Mishenko | Military Health Care Provider | 344e 100s, Slc, UT 84111 | 2020-08-13 |
| 1386264802 | Mckensee M Carter | Case Manager/Care Coordinator | 334 E 100 S, Salt Lake City, UT 84111 | 2020-04-24 |
| 1316421761 | Community Health Centers, Inc. | Social Worker | 610 S 200 E Ste #b, Salt Lake City, UT 84111 | 2018-09-21 |
| 1528545506 | Lauren Brittney Harman | Case Manager/Care Coordinator | 344 E. 100 S., Salt Lake City, UT 84111 | 2018-07-23 |
| 1851896484 | Shivani Chowdhary | Dentist | 370 E South Temple Ste 350, Salt Lake City, UT 84111 | 2018-03-26 |
| 1801390661 | Jaylee Marie Watman | Case Manager/Care Coordinator | 344 E. 100 S. Ste 301, Salt Lake City, UT 84111 | 2018-03-19 |
| 1467963918 | Victoira Julia Graham | Case Management | 344 East 100 South Ste 301, Salt Lake City, UT 84111 | 2017-10-23 |
| 1750805404 | Kayla Hymas | Behavioral Analyst | 243 E. 400 S., Slc, UT 84111 | 2017-08-02 |
| 1134643224 | Julie Peaslee | Counselor | 275 E South Temple Ste 110, Salt Lake City, UT 84111 | 2017-07-31 |
| Find all providers in zip 84111 | ||||
| Taxonomy Code | 3245S0500X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| Specialization | Substance Abuse Treatment, Children |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457697369 | Primary Childrens Medical Center | Substance Abuse Rehabilitation Facility | 5770 South 1500 West, Building A, Salt Lake City, UT 84123 | 2012-12-20 |
| 1801147533 | Craig A. Clifford | Substance Abuse Rehabilitation Facility | 344 E 100 S, Ste 301, Salt Lake City, UT 84111-1700 | 2012-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952790099 | Lorraine Michelle Ivey | Substance Abuse Rehabilitation Facility | 115 N 200 E, Washington, UT 84780-1642 | 2015-01-13 |
| 1912328576 | Heather Jenkins | Substance Abuse Rehabilitation Facility | 6200 South 3809 West, Kearns, UT 84129 | 2013-12-30 |
| 1477819878 | Mt Pleasant Campus | Substance Abuse Rehabilitation Facility | 1170 South 70 West, Mt. Pleasant, UT 84647 | 2012-04-10 |
| 1821382318 | Terri Butcher | Substance Abuse Rehabilitation Facility | 66 North 180 West, Ephriam, UT 84627-1111 | 2011-06-02 |
| 1154641926 | Triumph Youth Services | Substance Abuse Rehabilitation Facility | 58 S 950 W, Brigham City, UT 84302-4424 | 2010-06-03 |
| 1922323203 | Catalyst Residential Treatment | Substance Abuse Rehabilitation Facility | 970 S 1025 W, Brigham City, UT 84302-6711 | 2010-03-30 |
| 1003014648 | Eagle Ranch Academy | Substance Abuse Rehabilitation Facility | 115 W 1470 S, St George, UT 84770-6763 | 2007-07-05 |
| 1780782508 | Northstar Youth Academy LLC | Substance Abuse Rehabilitation Facility | 900 Columbia Ln, Provo, UT 84604-1320 | 2006-09-20 |
| 1639565260 | Salt Creek Addiction Recovery Services | Substance Abuse Rehabilitation Facility | 21360 N 1450 E, Moroni, UT 84646 | 2015-04-10 |
| 1396169728 | Apex Youth Services | Substance Abuse Rehabilitation Facility | 8606 N 11600 W, Thatcher, UT 84337-9103 | 2014-02-05 |
| Find all providers with the same taxonomy | ||||
| City | SALT LAKE CITY |
| Zip Code | 84111 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.