| Wasatch Homeless Health Care, Inc. | |
|
409 W 400 S Salt Lake City UT 84101-1135 | |
| (801) 364-0058 | |
| (801) 364-0161 |
| Full Name | Wasatch Homeless Health Care, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 409 W 400 S, Salt Lake City, Utah |
| Authorized Official Name and Position | Janida Emerson (CEO) |
| Authorized Official Contact | 8013640058 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wasatch Homeless Health Care, Inc. 409 W 400 S Salt Lake City UT 84101-1135 Ph: (801) 364-0058 | Wasatch Homeless Health Care, Inc. 409 W 400 S Salt Lake City UT 84101-1135 Ph: (801) 364-0058 |
| NPI Number | 1528128899 |
|---|---|
| Provider Enumeration Date | 12/09/2006 |
| Last Update Date | 04/24/2025 |
| Medicare PECOS PAC ID | 9032271697 |
|---|---|
| Medicare Enrollment ID | O20090305000400 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528128899 | NPI | - | NPPES |
| 201375 | Other | UT | BLACK LUNG |
| W0210 | Medicaid | UT | |
| 1528128899 | Medicaid | UT | |
| ========= | Medicaid | UT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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