Provider Demographics
NPI:1235625385
Name:CAREVOY LLC
Entity Type:Organization
Organization Name:CAREVOY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:M
Authorized Official - Last Name:OLSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-413-7784
Mailing Address - Street 1:50 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:LA VERKIN
Mailing Address - State:UT
Mailing Address - Zip Code:84745-5443
Mailing Address - Country:US
Mailing Address - Phone:801-413-7784
Mailing Address - Fax:
Practice Address - Street 1:50 S STATE ST
Practice Address - Street 2:
Practice Address - City:LA VERKIN
Practice Address - State:UT
Practice Address - Zip Code:84745-5443
Practice Address - Country:US
Practice Address - Phone:801-413-7784
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-02
Last Update Date:2018-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT60981251C00000X, 282NC2000X
UT54661261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC2000XHospitalsGeneral Acute Care HospitalChildren
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT60981OtherDAY TREATMENT
UT54661OtherINTENSIVE OUTPATIENT