Healthcare Provider Details
I. General information
NPI: 1457823940
Provider Name (Legal Business Name): IHC HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/20/2018
Last Update Date: 04/18/2025
Certification Date: 04/18/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
550 E 1400 N STE T
LOGAN UT
84341-2407
US
IV. Provider business mailing address
PO BOX 27128
SALT LAKE CITY UT
84127-0128
US
V. Phone/Fax
- Phone: 435-716-1320
- Fax:
- Phone: 435-716-1320
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084A0401X |
| Taxonomy | Addiction Medicine (Psychiatry & Neurology) Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0802X |
| Taxonomy | Addiction Psychiatry Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR0405X |
| Taxonomy | Substance Use Disorder Rehabilitation Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JP
VALIN
Title or Position: EVP CHIEF CLINICAL OFFICER
Credential: MD
Phone: 801-442-2000