PB UTAH SERVICES, LLC (NPI# 1760969182) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760969182 |
| Entity Type | Organization |
| Organization Name | PB UTAH SERVICES, LLC |
| Practice Address |
8072 S Highland Dr Salt Lake City UT 84121-5037 |
| Mailing Address |
7444 Long Ave Skokie IL 60077-3214 |
| Practice Telephone | 8019677664 |
| Mailing Telephone | 8473294100 |
| Mailing Fax Number | 8473294900 |
| Enumeration Date | 2018-07-27 |
| Last Update Date | 2018-07-27 |
| Authorized Official Name | BENJAMIN KLEIN (PRESIDENT) |
| Authorized Official Telephone | 8473294100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| Street Address |
8072 S HIGHLAND DR |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84121-5037 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144641564 | Ebh Southwest Services, Inc. | Substance Abuse Rehabilitation Facility | 8072 S Highland Dr, Salt Lake City, UT 84121-5037 | 2014-01-02 |
| 1316577596 | Tyler Rogers | Peer Specialist | 8072 S Highland Dr, Salt Lake City, UT 84121-5037 | 2020-01-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407483522 | Kaitlyn Horne | Behavior Technician | 6910 S. Highland Drive, Cottonwood Heights, UT 84121 | 2020-03-26 |
| 1952936387 | Jared Wells | Behavior Technician | 6910 S Highland Drive, Cottonwood Heights, UT 84121 | 2020-03-05 |
| 1518591874 | Slc Plastic Surgery LLC | Plastic Surgery | 6686 Highland Drive, Cottonwood Heights, UT 84121 | 2020-02-26 |
| 1093273708 | Anna O'hearon | Counselor | New Roads Behavioral Health, 2450 Fort Union Blvd, Cottonwood Heights, UT 84121 | 2019-03-12 |
| 1053883181 | Charles Keller IIi | Pediatrics | 2198 S Yvonne Rd #344, Salt Lake City, UT 84121 | 2018-12-31 |
| 1669964516 | Marissa King | Specialist | 1141 E. 3900 S. Suite 150a, Salt Lake, UT 84121 | 2018-06-05 |
| 1376044313 | Slpd Cottonwood LLC | Dentist | 7167 South Highland Drive, 200, Cottonwood Heights, UT 84121 | 2018-02-26 |
| 1700315462 | Nelson & Tillmann Family Dentistry, PC | Dentist | 5872 S. 900 E. Ste 202, Salt Lake City, UT 84121 | 2017-06-07 |
| 1912430588 | Wasatch Midwifery and Wellness, LLC | Dietitian, Registered | 6440 S Wasatch Blvd, Ste 140, Holladay, UT 84121 | 2017-04-10 |
| 1407308331 | Tina Polgar | Registered Nurse | 6244 Highland Drive, Murray, UT 84121 | 2016-10-26 |
| Find all providers in zip 84121 | ||||
| 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 | 84121 |
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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.