CANCER WELLNESS HOUSE, INC. (NPI# 1467071407) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467071407 |
| Entity Type | Organization |
| Organization Name | CANCER WELLNESS HOUSE, INC. |
| Practice Address |
59 S 1100 E Salt Lake City UT 84102-1508 |
| Practice Telephone | 8012362294 |
| Enumeration Date | 2020-04-09 |
| Last Update Date | 2020-04-09 |
| Authorized Official Name | DR. JOHN LIBRETT (CEO) |
| Authorized Official Telephone | 8015585950 |
| Authorized Official Credential | PHD, MPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| N | 251V00000X | Voluntary or Charitable | Agencies | ||
| N | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities | ||
| N | 261QC1500X |
Clinic/Center Specialization: Community Health |
Ambulatory Health Care Facilities | ||
| N | 261QH0100X |
Clinic/Center Specialization: Health Service |
Ambulatory Health Care Facilities | ||
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities | ||
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities | ||
| Y | 2083P0901X |
Preventive Medicine Specialization: Public Health & General Preventive Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CLINIC/GROUP PRACTICE | 01 | 01 |
| Other Name | Type Code |
|---|---|
| Survivor Wellness | Doing Business As Name - Organization |
| Street Address |
59 S 1100 E |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84102-1508 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942818604 | Wendy Vazquez | Behavior Technician | 515 S 700 E Suit 2a, Salt Lake City, UT 84102 | 2020-07-20 |
| 1407481245 | Odyssey House Inc | Family Medicine | 743 E 300 S, Salt Lake City, UT 84102 | 2020-03-11 |
| 1093359960 | Hayle Mayer | Behavior Technician | 515 S 700 E Salt Lake City, Suite 2a, Salt Lake, UT 84102 | 2019-11-04 |
| 1326680869 | Ronald Mcdonald House of The Intermountain Area | Meals | 935 E. South Temple, Salt Lake City, UT 84102 | 2019-10-16 |
| 1508419581 | Claire Pemberton | Behavior Technician | 327 E 1300 S, Apt 2, Salt Lake City, UT 84102 | 2019-07-19 |
| 1558923144 | Olivia Anne Hardwick | Social Worker | Transitions At Slrmc, 86 S. 1100 E. Suite 404, Salt Lake City, UT 84102 | 2019-07-03 |
| 1649741802 | Colten Vancampen | Behavior Technician | 515 S 700 E #2a, Salt Lake City, UT 84102 | 2018-12-16 |
| 1457847964 | Utah Podiatry Group PC | Podiatrist | 24 S 1100 E Ste 120, Salt Lake City, UT 84102 | 2018-07-09 |
| 1104311661 | Malorey Kooyman | Behavior Technician | 515 700 East, Suite 2a, Salt Lake City, UT 84102 | 2018-06-27 |
| 1700384930 | Utah Podiatry Group PC | Podiatrist | 82 S 1100 E Ste 301, Salt Lake City, UT 84102 | 2018-01-23 |
| Find all providers in zip 84102 | ||||
| Taxonomy Code | 2083P0901X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Public Health & General Preventive Medicine |
| Public health and general preventive medicine focuses on promoting health, preventing disease, and managing the health of communities and defined populations. These practitioners combine population-based public health skills with knowledge of primary, secondary, and tertiary prevention-oriented clinical practice in a wide variety of settings. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Preventive Medicine, 2007. http://www.abprevmed.org/. American Osteopathic Board of Preventive Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Preventive Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Preventive Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457806135 | Tamara Lewis Sheffield | Preventive Medicine | 36 S State St Fl 21, Salt Lake City, UT 84111-1630 | 2016-08-23 |
| 1447340047 | Paul Nathan Hopkins | Preventive Medicine | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2006-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346701075 | Passport Health Holdings, LLC | Preventive Medicine | 563 W 500 South, Suite 215, Bountiful, UT 84010-8172 | 2019-03-26 |
| 1275050353 | San Juan Public Health Special Service District | Preventive Medicine | 735 South 200 West, Suite B, Blanding, UT 84511 | 2017-08-29 |
| 1265733984 | John Charles Bailey | Preventive Medicine | 1330 E 2100 N, North Logan, UT 84341-2038 | 2010-11-11 |
| 1679732382 | Richard M Garden | Preventive Medicine | 14425 Bitterbrush Ln, Draper, UT 84020-9501 | 2008-06-06 |
| 1821203654 | Albert Gordon Reynolds | Preventive Medicine | 1871 West Cyn View Dr, Saint George, UT 84770 | 2007-05-14 |
| 1881652980 | Joseph K Miner | Preventive Medicine | 151 S University Ave, Suite 2800, Provo, UT 84601-4427 | 2006-05-01 |
| 1215427869 | Knew Visions Inc. | Preventive Medicine | 7984 S 1300 E, Sandy, UT 84094-0744 | 2018-05-18 |
| 1205377736 | Passport Health Holdings, LLC | Preventive Medicine | 1055 North 300 West, Ste 416, Provo, UT 84604-3354 | 2017-03-16 |
| 1477954402 | Passport Health Holdings LLC | Preventive Medicine | 7001 S 900 E, Ste 210, Midvale, UT 84047-5606 | 2014-09-09 |
| 1265695811 | Nichole Quick | Preventive Medicine | 3152 N University Ave Ste 220, Provo, UT 84604-4729 | 2008-07-03 |
| Find all providers with the same taxonomy | ||||
| City | SALT LAKE CITY |
| Zip Code | 84102 |
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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.