Healthcare Provider Details

I. General information

NPI: 1023949351
Provider Name (Legal Business Name): AMERITECH COLLEGE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12257 S BUSINESS PARK DR STE 100
DRAPER UT
84020-6540
US

IV. Provider business mailing address

12257 S BUSINESS PARK DR STE 100
DRAPER UT
84020-6540
US

V. Phone/Fax

Practice location:
  • Phone: 385-398-9244
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: ATAMI DE MAIN
Title or Position: FACULTY
Credential: PHD
Phone: 385-398-9244