Provider Demographics
NPI:1164908026
Name:HEADIN' HOME INC.
Entity Type:Organization
Organization Name:HEADIN' HOME INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DANTE
Authorized Official - Middle Name:C
Authorized Official - Last Name:PISTONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-910-2698
Mailing Address - Street 1:8478 S 4770 W
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84088-4790
Mailing Address - Country:US
Mailing Address - Phone:801-910-2698
Mailing Address - Fax:801-910-2698
Practice Address - Street 1:12300 S. 150 W.
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020
Practice Address - Country:US
Practice Address - Phone:801-910-2698
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-13
Last Update Date:2018-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health