West Side Center

LBN: Ddms Of Utah No.2
West Side Center is an health care organization with primary practice located at 4028 S 4800 W , West Valley City UT 84120-4537. The organization recently has only one registered license in Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities, which is considered as the primary health care specialty. Ddms Of Utah No.2 can be contacted via phone (801) 968-8122, or through Buck, Misti Ann via phone (801) 763-9299.

Contact Information

Primary practice address
4028 S 4800 W West Valley City UT 84120-4537
Phone: (801) 968-8122
Fax: (801) 968-8135
Website:
Map and Directions
Authorized official contact:
Name: Buck, Misti Ann D.O./ADMINISTRATOR
Phone: (801) 763-9299

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320600000X 2015-SHCF-101 Utah

Profile Details

NPI number 1558730218
LBN Legal business name Ddms Of Utah No.2
DBA Doing business as West Side Center
Authorized official Buck, Misti Ann D.O./ADMINISTRATOR
Entity Organization
Organization subpart 1 No
Enumeration date Sep 23rd, 2015
Last updated Jun 8th, 2023 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558730218 NPPES
Utah MEDICAID 2015-SHCF-101

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