PRIMARY CHILDRENS MEDICAL CENTER
NPI 1457697369
Substance Abuse Rehabilitation Facility - Substance Abuse Treatment, Children in Salt Lake City, UT

Active since December 20, 2012
5770 SOUTH 1500 WEST, BUILDING A, SALT LAKE CITY, UT 84123(801) 313-7800 Get Directions Write a Review

NPPES record last updated: December 20, 2012. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Primary Childrens Medical Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PRIMARY CHILDRENS MEDICAL CENTER (NPI 1457697369) is a healthcare organization registered as a substance abuse treatment, children in Salt Lake City, Utah and active in the NPI registry since December 2012. The organization lists William Thomas Kushner, Substance Abuse Counselor, as its authorized official.

NPPES Registry Identity

NPI1457697369
Entity TypeOrganization
Primary Taxonomy3245S0500X
Legal Business NamePRIMARY CHILDRENS MEDICAL CENTER
Location Address5770 SOUTH 1500 WEST, BUILDING ASalt Lake City, UT 84123
Mailing Address5770 South 1500 West, Building ASalt Lake City, UT 84123 · (801) 313-7800
Organization SubpartNo
Authorized OfficialWilliam Thomas KushnerSubstance Abuse Counselor · (801) 313-7858
Enumeration DateDecember 20, 2012
NPI 1457697369 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySubstance Abuse Rehabilitation Facility · Substance Abuse Treatment, ChildrenResidential Treatment Facilities
Taxonomy Code3245S0500X
License Licensed in UT · 2743846006
Definition

A facility or distinct part of a facility for children that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included.

5770 SOUTH 1500 WEST, Salt Lake City, UT 84123

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Social Worker (Clinical)
5770 SOUTH 1500 WEST
TAYLORSVILLE, UT 84123

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1457697369, enumerated as an "organization" on December 20, 2012.

The provider is located at 5770 SOUTH 1500 WEST BUILDING A SALT LAKE CITY, UT 84123 and the phone number is (801) 313-7800.

Substance Abuse Rehabilitation Facility with taxonomy code 3245S0500X and a focus in Substance Abuse Treatment, Children.