Healthcare Provider Details

I. General information

NPI: 1982529673
Provider Name (Legal Business Name): SIONE NGATUVAI CASE MANAGEMENT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 W 7200 S STE 104
MIDVALE UT
84047-1014
US

IV. Provider business mailing address

66 S BENELLI CT
VINEYARD UT
84059-4838
US

V. Phone/Fax

Practice location:
  • Phone: 385-404-4296
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: