| Organization Name: | IHC HEALTH SERVICES INC |
| NPI Number: | 1063536381 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHRISTINE J. JOHNSON (MANAGER, PROVIDER ENROLLMENT) |
| Mailing Address: | 1225 E Fort Union Blvd Suite 315 Midvale |
| State: | UT US |
| Postal Code: | 840471889 |
| Phone Number: | 8012334100 |
| Fax Number: | 8014420638 |
| NPI Enumeration Date: | 03/19/2007 |
| NPI Last Update Date: | 12/03/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM0801X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Mental Health (Including Community Mental Health Center) |
| Taxonomy Definition: | |