Provider Demographics
NPI:1346595519
Name:UNIVERSITY NEUROPSYCHIATRIC INSTITUTE
Entity Type:Organization
Organization Name:UNIVERSITY NEUROPSYCHIATRIC INSTITUTE
Other - Org Name:RECIVING CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:OYYCHIATRIC TECHNICIAN
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:DEON
Authorized Official - Last Name:SUTTON-SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-587-7988
Mailing Address - Street 1:721 W SUNNY RIVER RD APT 438
Mailing Address - Street 2:
Mailing Address - City:TAYLORSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84123-2847
Mailing Address - Country:US
Mailing Address - Phone:801-587-7988
Mailing Address - Fax:
Practice Address - Street 1:721 W SUNNY RIVER RD APT 438
Practice Address - Street 2:
Practice Address - City:TAYLORSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84123-2847
Practice Address - Country:US
Practice Address - Phone:801-587-7988
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LBN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-07-13
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT3106630870OtherUNI