BLACK SHIRT SERVICES


Address: 513 S 3040 W, Lehi, UT 84043-5636
Phone: 3855390035

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).

Provider Overview

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

Taxonomy

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

Office Location

Street Address 513 S 3040 W
City LEHI
State UT
Zip Code 84043-5636

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Taxonomy Information

Taxonomy Code 320900000X
Grouping Residential Treatment Facilities
Classification Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities

Taxonomy Definition

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]

Providers in the same taxonomy and state

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
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Competitor

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City LEHI
Zip Code 84043

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Dataset Information

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.

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