Provider Demographics
NPI:1932166980
Name:VALLEY BEHAVIORAL HEALTH INCORPORATED
Entity type:Organization
Organization Name:VALLEY BEHAVIORAL HEALTH INCORPORATED
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:JARED
Authorized Official - Middle Name:
Authorized Official - Last Name:SANFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-949-4864
Mailing Address - Street 1:PO BOX 572070
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84157-2070
Mailing Address - Country:US
Mailing Address - Phone:801-263-7138
Mailing Address - Fax:801-263-7203
Practice Address - Street 1:4460 S HIGHLAND DR
Practice Address - Street 2:#230
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84124-3543
Practice Address - Country:US
Practice Address - Phone:801-263-7138
Practice Address - Fax:801-263-7203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-26
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT101YP2500X, 103TC0700X, 1041C0700X, 106H00000X, 163WP0808X, 2084P0804X, 363LP0808X, 2084P0800X
261QM0801X, 261QR0405X, 291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental HealthGroup - Multi-Specialty
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use DisorderGroup - Multi-Specialty
No291U00000XLaboratoriesClinical Medical LaboratoryGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTCR0324OtherRAILROAD MEDICARE
UT2423OtherPEHP
UT464607Medicare PIN
UTU000003116Medicare PIN
UTU000003117Medicare PIN
UTU000003100Medicare PIN
UT000055502Medicare PIN
UT2423OtherPEHP
UT000057635Medicare PIN
UTU000003123Medicare PIN
UTCR0324OtherRAILROAD MEDICARE
UTU000002200Medicare PIN
UTU000003103Medicare PIN
UT464607Medicare Oscar/Certification
UT000057390Medicare PIN
UT000055495Medicare PIN
UT000003105Medicare PIN
UTU000003104Medicare PIN
UTU000003121Medicare PIN
UT000003106Medicare PIN
UT000003106Medicare PIN
UT464607Medicare PIN
UT2423OtherPEHP
UT=========031Medicaid
UT000055495Medicare PIN