Organization
ACCESS PRIVATE DUTY, LLC
Active
Organization
ACCESS PRIVATE DUTY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN W. SUMSION SPHR (HOME CARE DIRECTOR)
(801) 642-2665
Entity
Organization
Contact information
Practice address
359 E MAIN ST STE 4, AMERICAN FORK, UT 84003-2678
(801) 642-2665
(801) 642-2667
Mailing address
359 E. MAIN STREET SUITE # 4, AMERICAN FORK, UT 84003
(801) 642-2667
(801) 642-2667
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
2012-HHA-97078
UT
251B00000X
Case Management Agency
2012-HHA-97078
UT
251C00000X
Developmentally Disabled Services Day Training Agency
2012-HHA-97078
UT
251S00000X
Community/Behavioral Health Agency
2012-HHA-97078
UT
253Z00000X
In Home Supportive Care Agency
2012-HHA-97078
UT
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
2012-HHA-97078
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1083986947
—
UT
Enumeration date
01/07/2013
Last updated
01/07/2013
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