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General NPI Number Information
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NPI Number | 1063358117
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Entity Type | Organization
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Legal Business Name | AURA PRIME SUPPORT SERVICES
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Dates
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Enumeration Date | 04/28/2026
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Last Update Date | 04/28/2026
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Provider Practice Location Address
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Address Line | 5689 W PINEY VIEW CT
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City | SALT LAKE CITY
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State | UT
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Zip | 84118-6059
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Country | US
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Telephone | 801-815-3521
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Fax |
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Provider Business Mailing Address
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Address Line | 5689 W PINEY VIEW CT
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City | SALT LAKE CITY
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State | UT
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Zip | 84118-6059
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Country | US
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Telephone | 801-815-3521
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MATILDA NAMUCHANA MASUMBA
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Credential |
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Telephone | 801-815-3521
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 385HR2065X
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Taxonomy Name | Child Physical Disabilities Respite Care
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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