Provider Demographics
NPI:1083986947
Name:ACCESS PRIVATE DUTY, LLC
Entity Type:Organization
Organization Name:ACCESS PRIVATE DUTY, LLC
Other - Org Name:SENIOR CARE OF UTAH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER - DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:SUMSION
Authorized Official - Suffix:
Authorized Official - Credentials:PHR
Authorized Official - Phone:801-319-8833
Mailing Address - Street 1:3080 RICHMOND STREET
Mailing Address - Street 2:SUITE 106
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84106
Mailing Address - Country:US
Mailing Address - Phone:801-467-2880
Mailing Address - Fax:801-467-2940
Practice Address - Street 1:3080 RICHMOND ST APT 106
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84106-3087
Practice Address - Country:US
Practice Address - Phone:801-467-2880
Practice Address - Fax:801-467-2940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-07
Last Update Date:2012-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2012-HHA -97078251B00000X
UT2012-HHA - 97078251E00000X, 374U00000X
UT2011-HHA-97078253Z00000X
UT2012-HHA-97078372500000X, 372600000X, 376J00000X, 376K00000X, 385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty
No251E00000XAgenciesHome HealthGroup - Multi-Specialty
No372500000XNursing Service Related ProvidersChore ProviderGroup - Multi-Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite Care