BLACK SHIRT SERVICES (NPI# 1942748249) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1942748249 |
Entity Type | Organization |
Organization Name | BLACK SHIRT SERVICES |
Practice Address |
513 S 3040 W Lehi UT 84043-5636 |
Mailing Address |
Po Box 1008 Lehi UT 84043-7008 |
Practice Telephone | 3855390035 |
Practice Fax Number | 3854485123 |
Mailing Telephone | 3855390035 |
Mailing Fax Number | 3854485123 |
Enumeration Date | 2017-02-07 |
Last Update Date | 2017-02-07 |
Authorized Official Name | JASON HOKE (EXECUTIVE DIRECTOR) |
Authorized Official Telephone | 3855390035 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 102119070160 | UT | Residential Treatment Facilities |
Street Address |
513 S 3040 W |
City | LEHI |
State | UT |
Zip Code | 84043-5636 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1285264358 | Sojo Dental Lehi | Dentist | 3397 N. 1200 E., Ste #102, Lehi, UT 84043 | 2020-01-17 |
1932754165 | Mckenzie Ward | Speech-Language Pathologist | 2750 N Digital Dr Lehi, Lehi, UT 84043 | 2019-08-05 |
1780248336 | Kimberly Ann Henne | Nurse Practitioner | 3750 Digital Drive, Lehi, UT 84043 | 2019-04-30 |
1962961086 | Corporate Concierge | Optometrist | 4415 N Deer Ridge Trail, Lehi, UT 84043 | 2019-03-18 |
1518435692 | Brindie Allan Bishop | Midwife | 1202 W. 800 S., Lehi, UT 84043 | 2018-11-07 |
1841766821 | Dry Creek Pediatric Dentistry | Dentist | 3300 N Running Creek Way F101, Lehi, UT 84043 | 2018-10-17 |
1437634219 | Banyan Consulting | Assisted Living Facility | 301 N 1200 E, Lehi, UT 84043 | 2018-09-27 |
1174005508 | Cameron Ronald John | Psychologist | 3375 W. Mayflower Way, Suite A, Lehi, UT 84043 | 2018-09-01 |
1114415130 | Covington Senior Living of Lehi | Assisted Living Facility | 301 N. 1200 E., Lehi, UT 84043 | 2018-04-25 |
1669978060 | Mark Alleman | Physical Therapy Assistant | 2750 N Digital Dr., Lehi, UT 84043 | 2018-04-04 |
Find all providers in zip 84043 |
Taxonomy Code | 320900000X |
Grouping | Residential Treatment Facilities |
Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1881002061 | Compass Academy Transitional Services LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4800 E 17160 N, Moroni, UT 84646 | 2014-07-31 |
1073811196 | Chrysalis Texas | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 531 E 770 N, Orem, UT 84097-4102 | 2011-03-14 |
1780914572 | Kt&t, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1140 36th St Ste 285, Ogden, UT 84403-2064 | 2009-12-30 |
1386897650 | Friends for Life, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2228 S 2325 W, Syracuse, UT 84075-9282 | 2008-10-29 |
1164673331 | Empowered for Life, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5004 West Janette Drive, West Valley City, UT 84120 | 2008-10-07 |
1932359833 | Tri Connections, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1921 N 1120 W, Provo, UT 84604-1044 | 2008-09-26 |
1093920613 | Brighter Futures, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6138 S 380 W, Salt Lake City, UT 84107-6988 | 2007-05-14 |
1164542379 | Key Residential Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1361 S 740 E, Orem, UT 84097-8083 | 2007-03-30 |
1013059948 | Choices Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 484 South 1st East, Wellington, UT 84542-0155 | 2007-02-14 |
1730234733 | Eaton Alliance, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 9710 S 700 E, 111, Sandy, UT 84070-3594 | 2007-01-23 |
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.