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NPI Code Detail

MEDICARE: ALLIANCE HOUSE INC

MEDICARE: ALLIANCE HOUSE INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0850XAdult Mental Health Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1033585765
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALLIANCE HOUSE INC
Provider Business Mailing Address
First Line : 1724 S MAIN ST
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84115-1912
Country : US
Telephone Number : 801-486-5012
Fax Number :
Provider Business Practice Location Address
First Line : 1724 S MAIN ST
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84115-1912
Country : US
Telephone Number : 801-486-5012
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : PAIGE HUFF
Credential : LCSW
Telephone Number : 801-486-5012
Provider Enumeration Date : 08/17/2015
Last Update Date : 04/22/2020

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Directions to “ALLIANCE HOUSE INC ” Practice Location

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