| Summit County Clubhouse | |
|
1283 Deer Valley Dr Park City UT 84060-5182 | |
| (801) 930-0277 | |
| Not Available |
| Full Name | Summit County Clubhouse |
|---|---|
| Speciality | Case Manager/care Coordinator |
| Location | 1283 Deer Valley Dr, Park City, Utah |
| Authorized Official Name and Position | Amber Mackay (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8019300277 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Summit County Clubhouse Po Box 680861 Park City UT 84068-0861 Ph: (801) 930-0277 | Summit County Clubhouse 1283 Deer Valley Dr Park City UT 84060-5182 Ph: (801) 930-0277 |
| NPI Number | 1902456148 |
|---|---|
| Provider Enumeration Date | 09/19/2019 |
| Last Update Date | 11/27/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902456148 | NPI | - | NPPES |
| 1003101 | Medicaid | UT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 171M00000X | Case Manager/care Coordinator | (* (Not Available)) | Primary |
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