PROVO CARE CENTER (NPI# 1598764862) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598764862 |
| Entity Type | Organization |
| Organization Name | PROVO CARE CENTER |
| Practice Address |
256 E Center St Provo UT 84606-3107 |
| Mailing Address |
Po Box 1933 256 East Center Street Provo UT 84603-1933 |
| Practice Telephone | 1801373877 |
| Practice Fax Number | 1801373326 |
| Mailing Telephone | 1801373877 |
| Mailing Fax Number | 1801373326 |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. CATHERINE LYN PLANT (ADMINISTRATOR) |
| Authorized Official Telephone | 1803738771 |
| Authorized Official Credential | B.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | 2004-NCF-79 | UT | Nursing & Custodial Care Facilities |
| Street Address |
256 E CENTER ST |
| City | PROVO |
| State | UT |
| Zip Code | 84606-3107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053781054 | Rha Health Service Ut LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 256 E Center St, Provo, UT 84606-3107 | 2015-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053935551 | Olivia Stiles | Specialist/Technologist | 200 E 515 N, Provo, UT 84606 | 2020-06-01 |
| 1417439076 | Quin Spencer Volpe | Counselor | 1035 E 560 N, Provo, UT 84606 | 2018-08-30 |
| 1700365434 | Hyunwook Lee | Specialist/Technologist | 1369 S 1500 E, Provo, UT 84606 | 2018-08-13 |
| 1598268930 | Victor Bert Arthur Moxley | Specialist | 290 N 300 E, Provo, UT 84606 | 2018-03-12 |
| 1184132623 | Academy Dental LLC | Advanced Practice Dental Therapist | 488 N 100 E St., Provo, UT 84606 | 2018-01-18 |
| 1720433485 | Sean Lamb | Counselor | 231 S. 100 E., Provo, UT 84606 | 2016-05-02 |
| 1508236795 | Forever Young Dentistry Pllc | Clinic/Center | 2335 S. State Street, Ste #200, Provo, UT 84606 | 2015-09-30 |
| 1558766014 | Nancy Huber | Physician Assistant | Mountainland Community Health Center, 529 South State Street, Provo, UT 84606 | 2014-10-27 |
| 1356778377 | Myrna Suzanne Gillis | Marriage & Family Therapist | 1726 Buckley Drive, Provo, UT 84606 | 2013-10-04 |
| 1558651067 | Melissa Anne Mccreary | Counselor | 151 S.state St. University Ave., Ste 1400, Provo, UT 84606 | 2011-04-18 |
| Find all providers in zip 84606 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720098163 | Medallion Manor Inc. | Intermediate Care Facility, Mentally Retarded | 1701 W 600 S, Provo, UT 84601-3832 | 2006-08-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295267219 | Iron County Care Center LLC | Intermediate Care Facility, Mentally Retarded | 69 East 100 South, Parowan, UT 84761-0397 | 2017-03-29 |
| 1043518145 | Medallion Supported Living-payson | Intermediate Care Facility, Mentally Retarded | 2192 W State Rd, Payson, UT 84651-4539 | 2011-03-14 |
| 1538179981 | Medallion Supported Living | Intermediate Care Facility, Mentally Retarded | 651 E 200 S, Lehi, UT 84043-9703 | 2006-08-08 |
| 1841241445 | Trinity Mission Wide Horizons Residential Care Facility, Lp | Intermediate Care Facility, Mentally Retarded | 910 Monroe Blvd, Ogden, UT 84404-6434 | 2006-05-16 |
| 1457318917 | Mesa Vista Inc | Intermediate Care Facility, Mentally Retarded | 394 W 400 N, Orem, UT 84057-4663 | 2006-04-27 |
| 1871570374 | West Jordan Care Center | Intermediate Care Facility, Mentally Retarded | 3350 W 7800 S, West Jordan, UT 84088-4506 | 2005-12-27 |
| 1396745378 | Rha Community Services of Utah | Intermediate Care Facility, Mentally Retarded | 642 University St, Salt Lake City, UT 84102-3213 | 2005-07-29 |
| 1245230820 | Rha Community Services of Utah | Intermediate Care Facility, Mentally Retarded | 645 S 1300 E, Salt Lake City, UT 84102-3206 | 2005-07-26 |
| 1033118674 | Rha Community Services of Utah | Intermediate Care Facility, Mentally Retarded | 340 N 100 W, Bountiful, UT 84010-6054 | 2005-07-15 |
| 1477552099 | Hidden Hollow Care Center | Intermediate Care Facility, Mentally Retarded | 261 W 2000 S, Orem, UT 84058-7417 | 2005-07-15 |
| 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.