Banellis, Daniel Edmund
Banellis, Daniel Edmund is an sole proprietor health care provider with primary practice located at 411 Grant St , Salt Lake City UT 84116-2725. He recently has only one registered license in Residential Treatment Facilities / Substance Abuse Rehabilitation Facility, which is considered as his primary health care specialty. Banellis, Daniel Edmund can be contacted via phone (801) 359-8862.Contact Information
Primary practice address
411 Grant St
Salt Lake City UT 84116-2725
Phone: (801) 359-8862
Fax: (801) 359-8510
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Residential Treatment Facilities / Substance Abuse Rehabilitation Facility | 324500000X |
Profile Details
| NPI number | 1194087015 |
|---|---|
| LBN Legal business name | Banellis, Daniel Edmund |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 15th, 2012 |
| Last updated | Jun 15th, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1194087015 | NPPES |
| Utah | MEDICAID | 1376550566 |
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