Organization
EQUITABLE HEALTH CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LANCE JOHNSON (DIRECTOR)
(801) 949-4021
Entity
Organization
Contact information
Practice address
626 RXR PLZ FL 6TH, UNIONDALE, NY 11556-3829
(801) 949-4021
Mailing address
626 RXR PLZ FL 6TH, UNIONDALE, NY 11556-3829
(801) 949-4021
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
251E00000X
Home Health Agency
—
—
261Q00000X
Clinic/Center
—
—
261QP0904X
Federal Public Health Clinic/Center
—
—
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
—
—
Other
Enumeration date
12/24/2025
Last updated
01/09/2026
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