| Sjv, Inc. A Professional Corporation | |
|
4505 Wasatch Blvd Suite 320 Salt Lake City UT 84124-4709 | |
| (801) 277-8100 | |
| (801) 277-8800 |
| Full Name | Sjv, Inc. A Professional Corporation |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 4505 Wasatch Blvd, Salt Lake City, Utah |
| Authorized Official Name and Position | Steve Varechok (LICENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 8012778100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sjv, Inc. A Professional Corporation 4505 Wasatch Blvd Suite 320 Salt Lake City UT 84124-4709 Ph: (801) 277-8100 | Sjv, Inc. A Professional Corporation 4505 Wasatch Blvd Suite 320 Salt Lake City UT 84124-4709 Ph: (801) 277-8100 |
| NPI Number | 1568529188 |
|---|---|
| Provider Enumeration Date | 01/02/2007 |
| Last Update Date | 02/26/2008 |
| Medicare PECOS PAC ID | 2860578630 |
|---|---|
| Medicare Enrollment ID | O20080320000112 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568529188 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 134414-3501 (Utah) | Primary |
| Provider Name | Steven J Varechok |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376690610 PECOS PAC ID: 6709976624 Enrollment ID: I20071217000031 |
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