Summit County Clubhouse

LBN: Summit County Clubhouse
Summit County Clubhouse is an health care organization with primary practice located at 1283 Deer Valley Dr , Park City UT 84060-5182. The organization recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Other Service Providers / Case Manager/Care Coordinator. Other Service Providers / Case Manager/Care Coordinator is the primary health care specialty. Summit County Clubhouse can be contacted via phone (801) 930-0277, or through Mackay, Amber via phone (801) 930-0277.

Contact Information

Primary practice address
1283 Deer Valley Dr Park City UT 84060-5182
Phone: (801) 930-0277
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Mackay, Amber SSW
Phone: (801) 930-0277

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Other Service Providers / Case Manager/Care Coordinator 171M00000X

Profile Details

NPI number 1902456148
LBN Legal business name Summit County Clubhouse
DBA Doing business as
Authorized official Mackay, Amber SSW
Entity Organization
Organization subpart 1 No
Enumeration date Sep 19th, 2019
Last updated Nov 27th, 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 1902456148 NPPES
Utah MEDICAID 1003101

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