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:
Health care specialties
| Specialty | Code | License # | 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 last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1902456148 | NPPES |
| Utah | MEDICAID | 1003101 |
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