Provider Demographics
NPI:1023088366
Name:VALLEY MENTAL HEALTH
Entity type:Organization
Organization Name:VALLEY MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PAPENFUSS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:801-538-2057
Mailing Address - Street 1:740 EAST 300 SOUTH
Mailing Address - Street 2:#103
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84102
Mailing Address - Country:US
Mailing Address - Phone:801-440-0546
Mailing Address - Fax:
Practice Address - Street 1:530 EAST 500 SOUTH
Practice Address - Street 2:#10
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84102
Practice Address - Country:US
Practice Address - Phone:801-538-2057
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT316045-3102251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care