LAVALLEE CORPORATION (NPI# 1134310956) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134310956 |
| Entity Type | Organization |
| Organization Name | LAVALLEE CORPORATION |
| Other Organization Name | PHASES OF CHANGE |
| Practice Address |
121 Country Club Dr Ogden UT 84405-2704 |
| Practice Telephone | 8016950386 |
| Mailing Telephone | 8016950386 |
| Enumeration Date | 2007-08-06 |
| Last Update Date | 2007-08-06 |
| Authorized Official Name | JEFFREY A LAVALLEE (CEO) |
| Authorized Official Telephone | 8016950386 |
| Authorized Official Credential | LMFT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | 3314093902 | UT | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | 788007788057 | 05 |
| Other Name | Type Code |
|---|---|
| Phases of Change | Doing Business As Name - Organization |
| Street Address |
121 COUNTRY CLUB DR |
| City | OGDEN |
| State | UT |
| Zip Code | 84405-2704 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669028171 | Alyssa House | Behavioral Analyst | 4933 1500 West #110, Riverdale, UT 84405 | 2019-08-12 |
| 1518525989 | Petersen Farms Assisted Living & Memory Care | Assisted Living Facility | 6980 S. 475 E., South Weber, UT 84405 | 2019-05-31 |
| 1376038141 | National Vision, Inc. | Technician/Technologist | 821 West Riverdale Road, Riverdale, UT 84405 | 2018-06-25 |
| 1194218461 | South Weber City | Ambulance | 7365 S 1375 E, South Weber, UT 84405 | 2018-06-12 |
| 1528572682 | Sandra Jo Scott | Dental Hygienist | 264 W Ridgeline Dr, Washington Terrace, UT 84405 | 2017-11-28 |
| 1376079061 | Loretta Shupe | Registered Nurse | 5319 S 500 E, Ogden, UT 84405 | 2017-05-02 |
| 1134661374 | Randy Ferrin | Registered Nurse | 5697 Maplewood Drive, South Ogden, UT 84405 | 2016-11-04 |
| 1871046284 | Karla Rosen | Counselor | 5202 S. Freeway Park Dr., Riverdale, UT 84405 | 2016-08-02 |
| 1053784520 | Jenifer Rebecca Nilson Smith | Physical Therapist | 5648 S. Adams Ave, Washington Terrace, UT 84405 | 2015-11-05 |
| 1972976454 | Jenniferlyn Fletcher | Physical Therapy Assistant | 5648 South Adams Ave, Washington Terrace, UT 84405 | 2015-11-05 |
| Find all providers in zip 84405 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932646148 | Canyon River Ranch | Community Based Residential Treatment Facility, Mental Illness | 244 Ogden Cyn, Ogden, UT 84401-0958 | 2017-01-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144872516 | Davis Behavioral Health Inc | Community Based Residential Treatment Facility, Mental Illness | 2250 N Robins Dr, Layton, UT 84041-1140 | 2019-07-15 |
| 1710444245 | New Focus Academy | Community Based Residential Treatment Facility, Mental Illness | 1268 N Valley Heights Cir, Heber City, UT 84032-4591 | 2019-02-20 |
| 1871066365 | Sundance Canyon East | Community Based Residential Treatment Facility, Mental Illness | 11457 S 700 W, Draper, UT 84020-9426 | 2019-01-07 |
| 1508307083 | Jennifer Carlson | Community Based Residential Treatment Facility, Mental Illness | 8375 South 700east, Sandy, UT 84070 | 2017-03-16 |
| 1629513833 | Telos | Community Based Residential Treatment Facility, Mental Illness | 661 S 1200 W, Orem, UT 84058-5817 | 2016-12-23 |
| 1982150256 | Sequel Youth Services of Falcon Ridge Ranch | Community Based Residential Treatment Facility, Mental Illness | 633 East Highway, Virgin, UT 84779 | 2016-08-28 |
| 1073069340 | Sequel Youth Services of Mt. Pleasant | Community Based Residential Treatment Facility, Mental Illness | 1100 South 70 West, Mt. Pleasant, UT 84647 | 2016-08-28 |
| 1942667597 | Mosaic House- Certs | Community Based Residential Treatment Facility, Mental Illness | 1488 E Vine St, Murray, UT 84121-1958 | 2016-01-26 |
| 1427425859 | Gateway Academy, LLC | Community Based Residential Treatment Facility, Mental Illness | 2487 S 700 E, Salt Lake City, UT 84106-1722 | 2015-09-02 |
| 1366863185 | Pine Ridge Behavioral Health LLC | Community Based Residential Treatment Facility, Mental Illness | 10380 East 22000 North, Fairview, UT 84629 | 2013-12-20 |
| Find all providers with the same taxonomy | ||||
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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.