Provider Demographics
NPI:1518155696
Name:CJS1 ENTERPRISES, INC.
Entity Type:Organization
Organization Name:CJS1 ENTERPRISES, INC.
Other - Org Name:MOUNTAIN VIEW HEALTH AND WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:BECK-SCHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:801-560-1581
Mailing Address - Street 1:3760 SADDLEBACK RD
Mailing Address - Street 2:
Mailing Address - City:PARK CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84098-4800
Mailing Address - Country:US
Mailing Address - Phone:801-560-1581
Mailing Address - Fax:
Practice Address - Street 1:6546 NORTH LANDMARK DRIVE
Practice Address - Street 2:STE E
Practice Address - City:PARK CITY
Practice Address - State:UT
Practice Address - Zip Code:84098
Practice Address - Country:US
Practice Address - Phone:801-560-1581
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CJS1 ENTERPRISES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-10-14
Last Update Date:2015-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT368796-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTU74740Medicare UPIN