BRUCE LEE (NPI# 1134518210) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134518210 |
| Entity Type | Individual |
| Full Name | BRUCE LEE |
| Practice Address |
344 E 100 S Ste 301 Salt Lake City UT 84111-1727 |
| Mailing Address |
344 East 100 South Ste.301 Slc UT 84111 |
| Practice Telephone | 8013224257 |
| Mailing Telephone | 8013224257 |
| Enumeration Date | 2015-01-13 |
| Last Update Date | 2015-01-13 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033687272 | Bruce Sangho Lee | Durable Medical Equipment & Medical Supplies | 534 Cardinal St, Brea, CA 92823-1005 | 2018-11-06 |
| 1316069867 | Bruce Lee | Chiropractor | 3911 N 10th St, Suite G, Mcallen, TX 78501-2036 | 2007-04-04 |
| 1104998665 | Bruce B Lee | Chiropractor | 2225a E. 7th Avenue, Flagstaff, AZ 86004-3737 | 2006-11-13 |
| 1528145166 | Bruce D Lee | Chiropractor | 3200 W 72nd Ave, Westminster, CO 80030-5477 | 2006-11-01 |
| 1568563807 | Bruce H Lee | Dentist | 181 S Gulling St, Portola, CA 96122-9609 | 2006-09-26 |
| 1982681011 | Bruce W Lee | Dentist | 20250 E Smoky Hill Rd Unit 5, Suite 202, Centennial, CO 80015-3118 | 2005-12-29 |
| 1205399391 | Bruce Lee | Student in an Organized Health Care Education/Training Program | 1425 Portland Ave, Rochester, NY 14621-3001 | 2019-04-07 |
| 1639674948 | Bruce Forbes Lee | Social Worker | 5255 Loughboro Rd Nw, Washington, DC 20016-2633 | 2018-03-28 |
| 1851631899 | Bruce Lee | Physical Therapist | 1920 Maple Ave, Lisle, IL 60532-2179 | 2013-02-28 |
| 1629148994 | Bruce Bernard Lee | Obstetrics & Gynecology | 966 Cass St, Suite 200, Monterey, CA 93940 | 2006-11-08 |
| Street Address |
344 E 100 S STE 301 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84111-1727 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649451642 | Eric John Schmidt | Social Worker | 344 E 100 S Ste 301, Salt Lake City, UT 84111-1727 | 2007-11-18 |
| 1992311906 | Chris Aaron Johns | Case Manager/Care Coordinator | 344 E 100 S Ste 301, Salt Lake City, UT 84111-1727 | 2020-09-16 |
| 1366057770 | Jacqualine Long | Case Manager/Care Coordinator | 344 E 100 S Ste 301, Salt Lake City, UT 84111-1727 | 2020-09-11 |
| 1992316699 | Michael Dandin | Counselor | 344 E 100 S Ste 301, Salt Lake City, UT 84111-1727 | 2020-08-14 |
| 1265043954 | Soana Talau Kelepi | Case Manager/Care Coordinator | 344 E 100 S Ste 301, Salt Lake City, UT 84111-1727 | 2020-08-14 |
| 1528678166 | Lori Frances Ili | Case Manager/Care Coordinator | 344 E 100 S Ste 301, Salt Lake City, UT 84111-1727 | 2020-08-07 |
| 1558971234 | Cristie Anderson | Case Manager/Care Coordinator | 344 E 100 S Ste 301, Salt Lake City, UT 84111-1727 | 2020-08-06 |
| 1629687884 | Kinley Ashton Millett | Case Manager/Care Coordinator | 344 E 100 S Ste 301, Salt Lake City, UT 84111-1727 | 2020-07-23 |
| 1225646565 | Denise Lee Tolbert | Case Manager/Care Coordinator | 344 E 100 S Ste 301, Salt Lake City, UT 84111-1727 | 2020-07-22 |
| 1437767068 | Tammy Checketts | Case Manager/Care Coordinator | 344 E 100 S Ste 301, Salt Lake City, UT 84111-1727 | 2020-07-20 |
| Find all providers in the same location | ||||
| 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 | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063013886 | Brc Wellness LLC | Substance Abuse Rehabilitation Facility | 4911 S 900 E Ste B, Salt Lake City, UT 84117-5747 | 2020-11-06 |
| 1528444999 | Jrl Broken Arrow LLC | Substance Abuse Rehabilitation Facility | 2610 S Highland Dr, Salt Lake City, UT 84106-2714 | 2015-08-07 |
| 1962891978 | Chris Ostler | Substance Abuse Rehabilitation Facility | 344 East 100 South,ste 301, Salt Lake City, UT 84111 | 2015-01-14 |
| 1144641564 | Ebh Southwest Services, Inc. | Substance Abuse Rehabilitation Facility | 8072 S Highland Dr, Salt Lake City, UT 84121-5037 | 2014-01-02 |
| 1093152290 | Sober Living Properties | Substance Abuse Rehabilitation Facility | 1027 E Millcreek Way, Salt Lake City, UT 84106-2015 | 2013-05-29 |
| 1831482231 | Project Recovery, Inc. | Substance Abuse Rehabilitation Facility | 1338 Foothill Dr, 162, Salt Lake City, UT 84108-2321 | 2011-05-18 |
| 1043515364 | The Haven | Substance Abuse Rehabilitation Facility | 1450 S West Temple, Apt F 304, Salt Lake City, UT 84115-5203 | 2011-01-18 |
| 1326358599 | Odyssey House | Substance Abuse Rehabilitation Facility | 340 East 100 South, Odyssey House, Salt Lake City, UT 84111 | 2010-10-20 |
| 1861524464 | Journey At Willowcreek | Substance Abuse Rehabilitation Facility | 8072 Highland Dr, Salt Lake City, UT 84121-5037 | 2007-03-09 |
| 1164521852 | Helping Hand Association | Substance Abuse Rehabilitation Facility | 974 East South Temple, Salt Lake City, UT 84102-1413 | 2006-09-21 |
| Find all providers in SALT LAKE CITY | ||||
| 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.