HOLLADAY HEALTHCARE CENTER
NPI 1962955237
Skilled Nursing Facility in Salt Lake City, UT

Active since August 03, 2016CLIA 46D0713962 · Waiver
4782 S HOLLADAY BLVD, SALT LAKE CITY, UT 84117(801) 277-7002(801) 272-0622 Get Directions Write a Review

NPPES record last updated: March 2, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Holladay Healthcare Center NPPES

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

HOLLADAY HEALTHCARE CENTER (NPI 1962955237) is a healthcare organization registered as a skilled nursing facility in Salt Lake City, Utah and active in the NPI registry since August 2016. The organization holds a CLIA Waiver certificate valid through January 13, 2028 and lists Soon Burnam, Treasurer Of Management Company, as its authorized official.

NPPES Registry Identity

NPI1962955237
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameBEAVER VALLEY HOSPITAL
Location Address4782 S HOLLADAY BLVDSalt Lake City, UT 84117-5444
Mailing Address4782 S Holladay BlvdSalt Lake City, UT 84117-5444 · (801) 277-7002 · Fax (801) 272-0622
Fax(801) 272-0622
Organization SubpartNo
Authorized OfficialSoon BurnamTreasurer Of Management Company · (949) 540-1249
Enumeration DateAugust 3, 2016
Last NPPES UpdateMarch 2, 2021
NPPES CertifiedMarch 2, 2021
NPI 1962955237 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
4782 S HOLLADAY BLVD, Salt Lake City, UT 84117

Other Names 1

Doing Business AsHolladay Healthcare Center

Accepted Insurance

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 46D0713962

Holladay Health Care Center · Salt Lake City, UT
Active · expires Jan 13, 2028
CLIA Number46D0713962
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateJanuary 14, 2026
Certificate Expiration DateJanuary 13, 2028
Laboratory DirectorVijay Maiya
Laboratory Phone(801) 277-7002
Laboratory LocationHolladay Health Care Center4782 S Holladay Blvd, Salt Lake City, UT 84117
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 9

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

Occupational Therapy Assistant
4782 S HOLLADAY BLVD
HOLLADAY, UT 84117
Physical Therapist
4782 S HOLLADAY BLVD
HOLLADAY, UT 84117
Speech-Language Pathologist
4782 S HOLLADAY BLVD
HOLLADAY, UT 84117
Recreation Therapist
4782 S HOLLADAY BLVD
HOLLADAY, UT 84117
Occupational Therapy Assistant
4782 S HOLLADAY BLVD
HOLLADAY, UT 84117
Recreation Therapist
4782 S HOLLADAY BLVD
HOLLADAY, UT 84117
Clinic/Center (Physical Therapy)
4782 S HOLLADAY BLVD
SALT LAKE CITY, UT 84117
Occupational Therapist
4782 S HOLLADAY BLVD
HOLLADAY, UT 84117

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 Beaver Valley Hospital's NPI number?

The NPI number for Beaver Valley Hospital is 1962955237. It was assigned to this organization in the NPPES registry on August 3, 2016. The provider is doing business as Holladay Healthcare Center.

Where is Beaver Valley Hospital located?

Beaver Valley Hospital is located at 4782 S Holladay Blvd, Salt Lake City, UT 84117. The listed phone number is (801) 277-7002.

What is Beaver Valley Hospital's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does Beaver Valley Hospital hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 46D0713962) is associated with this NPI, valid through January 13, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Beaver Valley Hospital accept?

Health plans from BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah, Select Health and University of Utah Health Plans list Beaver Valley Hospital as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Beaver Valley Hospital was last updated on March 2, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.