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General NPI Number Information
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NPI Number | 1528128899
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Entity Type | Organization
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Legal Business Name | WASATCH HOMELESS HEALTH CARE, INC.
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Dates
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Enumeration Date | 12/09/2006
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Last Update Date | 04/24/2025
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Provider Practice Location Address
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Address Line | 409 W 400 S
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City | SALT LAKE CITY
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State | UT
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Zip | 84101-1135
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Country | US
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Telephone | 801-364-0058
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Fax | 801-364-0161
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Provider Business Mailing Address
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Address Line | 409 W 400 S
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City | SALT LAKE CITY
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State | UT
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Zip | 84101-1135
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Country | US
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Telephone | 801-364-0058
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Fax | 801-364-0161
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Authorized Official
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Title or Position | CEO
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Name | MRS. JANIDA EMERSON
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Credential |
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Telephone | 801-364-0058
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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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 | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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