NPI 1629129689

Subtenant 1430 East 4500 South LLC

Organisation Psychiatric Hospital Salt Lake City, UT

Practice location

Address: 1430 East 4500 South, Salt Lake City, UT 84117-4208
Phone: (801) 272-8000
Fax: (801) 272-4983
Mailing address: 6400 Oak Canyon 200, Irvine, CA 92618-5233

Authorised official

Name: Thomas V Croal
Title: Svp & Cfo
Phone: (949) 240-7200

Registered specialties (2)

Psychiatric Hospital Primary

Hospitals Taxonomy 283Q00000X Licence 2011-HOSP-100053 (UT)

Other Psychiatric Hospital providers in Utah →

Skilled Nursing Facility

Nursing & Custodial Care Facilities Taxonomy 314000000X

Other Skilled Nursing Facility providers in Utah →

Registry record

NPI: 1629129689
Entity type: Organization
NPI issued: 16 Jan 2007
Record last updated: 26 Jul 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.