1447495981 NPI number — MIDTOWN COMMUNITY HEALTH CENTER INC

Table of content: LATOYIA SHONTE LEVERETTE RN (NPI 1891579074)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447495981 NPI number — MIDTOWN COMMUNITY HEALTH CENTER INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MIDTOWN COMMUNITY HEALTH CENTER INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447495981
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/16/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2240 ADAMS AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OGDEN
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84401-1511
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
801-393-5355
Provider Business Mailing Address Fax Number:
801-394-4609

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
781 25TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OGDEN
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84401-2509
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-622-1451
Provider Business Practice Location Address Fax Number:
833-428-8441
Provider Enumeration Date:
12/12/2008

Additional Information

Authorized Official

Authorized Official Last Name:
MARTINEZ
Authorized Official First Name:
ALICIA
Authorized Official Middle Name:
DACY
Authorized Official Title or Position:
CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
801-334-1321

Provider Taxonomy Codes

  • Taxonomy code: 261QC1500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QF0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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