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DEER HOLLOW LAKESIDE LLC
NPI 1487160875
Substance Abuse Rehabilitation Facility in Brighton, UT

Active since December 20, 2017CLIA 46D2284218 · Waiver
7904 S NORDIC TRAIL LN, BRIGHTON, UT 84121(801) 679-6669(801) 203-9216 Get Directions Write a Review

NPPES record last updated: February 23, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Feb 23, 2018, Dec 20, 2017 (2 updates tracked since 2017).

About Deer Hollow Lakeside Llc NPPES

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

DEER HOLLOW LAKESIDE LLC (NPI 1487160875) is a healthcare organization registered as a substance abuse rehabilitation facility in Brighton, Utah and active in the NPI registry since December 2017. The organization holds a CLIA Waiver certificate valid through June 19, 2027 and lists Tina R Romano, Director Of Financial Operations, as its authorized official.

NPPES Registry Identity

NPI1487160875
Entity TypeOrganization
Primary Taxonomy324500000X
Legal Business NameDEER HOLLOW LAKESIDE LLC
Location Address7904 S NORDIC TRAIL LNBrighton, UT 84121-1000
Mailing AddressPo Box 1078Draper, UT 84020-1078 · (801) 679-6669 · Fax (801) 203-9216
Phone(801) 679-6669
Fax(801) 203-9216
Organization SubpartNo
Authorized OfficialTina R RomanoDirector Of Financial Operations · (801) 759-1734
Enumeration DateDecember 20, 2017
Last NPPES UpdateFebruary 23, 20182 updates tracked since enumeration
✔ NPI 1487160875 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities
Taxonomy Code324500000X
Licenses✔ Licensed in UT · 51884✔ Licensed in UT · 53992✔ Licensed in UT · 53972
Definition
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.
7904 S NORDIC TRAIL LN, Brighton, UT 84121
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 46D2284218

Deer Hollow - Trailside · Draper, UT
Active · expires Jun 19, 2027
CLIA Number46D2284218
Laboratory TypeResidential Treatment Cen
Certificate Effective DateJune 20, 2025
Certificate Expiration DateJune 19, 2027
Laboratory DirectorErica Agliano
Laboratory Phone(801) 679-6669
Laboratory LocationDeer Hollow - Trailside13013 Shadowlands Lane, Draper, UT 84020
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

TIFFANY LEE MURPHY RN
Registered Nurse
7904 S NORDIC TRAIL LN
BRIGHTON, UT 84121
Salt Lake County (801) 679-6669

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Deer Hollow Lakeside LLC's NPI number?

The NPI number for Deer Hollow Lakeside LLC is 1487160875. It was assigned to this organization in the NPPES registry on December 20, 2017.

Where is Deer Hollow Lakeside LLC located?

Deer Hollow Lakeside LLC is located at 7904 S Nordic Trail Ln, Brighton, UT 84121. The listed phone number is (801) 679-6669.

What is Deer Hollow Lakeside LLC's specialty?

The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

Does Deer Hollow Lakeside LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 46D2284218) is associated with this NPI, valid through June 19, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Deer Hollow Lakeside LLC was last updated on February 23, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.