ALTIUM HEALTH LLC (NPI# 1235787870) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235787870 |
| Entity Type | Organization |
| Organization Name | ALTIUM HEALTH LLC |
| Other Organization Name | SUNDANCE BEHAVIORAL HEALTH LLC |
| Practice Address |
7613 S Jordan Landing Blvd Ste 200 West Jordan UT 84084-1973 |
| Practice Telephone | 4258904777 |
| Enumeration Date | 2019-08-27 |
| Last Update Date | 2020-08-27 |
| Authorized Official Name | SIAMAK KHADJENOURY (CEO) |
| Authorized Official Telephone | 8016139843 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 2084P0802X |
Psychiatry & Neurology Specialization: Addiction Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities | ||
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| N | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
Behavioral Health & Social Service Providers | ||
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 106H00000X | Marriage & Family Therapist | Behavioral Health & Social Service Providers | ||
| N | 171M00000X | Case Manager/Care Coordinator | Other Service Providers | ||
| N | 175T00000X | Peer Specialist | Other Service Providers | ||
| N | 207LA0401X |
Anesthesiology Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 2084A0401X |
Psychiatry & Neurology Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Sundance Behavioral Health LLC | Former Legal Business Name - Organization |
| Street Address |
7613 S JORDAN LANDING BLVD STE 200 |
| City | WEST JORDAN |
| State | UT |
| Zip Code | 84084-1973 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396351383 | National Vision Inc | Optometrist | 3857 West Campus View Drive, Suite 110, West Jordan, UT 84084 | 2020-09-16 |
| 1386267938 | Parker Brown | Dentist | Jordan Valley Dental, 7452 S Campus Drive, West Jordan, UT 84084 | 2020-05-18 |
| 1952809873 | David D. Allred Counseling & Consulting, LLC | Marriage & Family Therapist | 1365 W Green Hedge Way, West Jordan, UT 84084 | 2018-01-25 |
| 1720514268 | Utah Podiatric Physicians and Surgeons Group LLC | Podiatrist | 7000 S 1561 W, #100, West Jordan, UT 84084 | 2017-05-03 |
| 1245787829 | Josh Sullivan | Social Worker | 7395 S Paddington Rd, West Jordan, UT 84084 | 2016-09-01 |
| 1457752503 | Eaze Bracing | Prosthetic/Orthotic Supplier | 1324 W 7125 S, West Jordan, UT 84084 | 2014-09-09 |
| 1437595030 | Medico Transport System | Ambulance | 7365 S 4570 W, South Jordan, UT 84084 | 2013-05-22 |
| 1659612737 | Lifecare Specialty | Pharmacy | 1646 Sunrise Place Ste B, West Jordan, UT 84084 | 2013-03-14 |
| 1518217942 | Luciane Lopes De Oliveira | Student in an Organized Health Care Education/Training Program | 7601 Redwood Road, West Jordan, UT 84084 | 2012-09-13 |
| 1023368636 | Chelsey Tautkus | Social Worker | 7601 South Redwood Road, Building E, West Jordan, UT 84084 | 2012-09-12 |
| Find all providers in zip 84084 | ||||
| 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 |
| 1891307104 | Steps Recovery Center | Substance Abuse Rehabilitation Facility | 345 E 4500 S # 100-140, Murray, UT 84107-3991 | 2020-08-18 |
| 1104460666 | Active Recovery, LLC | Substance Abuse Rehabilitation Facility | 25 S Main St # 212, Centerville, UT 84014-1840 | 2019-10-28 |
| 1437709441 | Insight Recovery Cedar City, LLC | Substance Abuse Rehabilitation Facility | 1050 W Old Highway 91, Parowan, UT 84761-7725 | 2019-09-12 |
| 1316506470 | Evnsq, LLC | Substance Abuse Rehabilitation Facility | 5162 S Highland Dr, Holladay, UT 84117-7048 | 2019-06-11 |
| 1114584356 | Juniper Canyon Recovery Center for Women, LLC | Substance Abuse Rehabilitation Facility | 520 North Aspen Road, Loa, UT 84747-8474 | 2019-05-23 |
| 1750948030 | Liberty Addiction Recovery Centers LLC | Substance Abuse Rehabilitation Facility | 10458 N 6570 W, Highland, UT 84003-9311 | 2019-05-22 |
| 1235793290 | Mountain Valley Recovery LLC | Substance Abuse Rehabilitation Facility | 9431 N 400 W, Holden, UT 84636 | 2019-04-25 |
| 1346803525 | Brookstone Foundation | Substance Abuse Rehabilitation Facility | 198 N 100 E # 198n100e, St George, UT 84770-2831 | 2019-04-15 |
| 1639649684 | Sterling Recovery | Substance Abuse Rehabilitation Facility | 525 W 465 N Ste 130, Providence, UT 84332-5604 | 2018-12-03 |
| Find all providers with the same taxonomy | ||||
| City | WEST JORDAN |
| Zip Code | 84084 |
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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.