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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