Sundance Behavioral Health LLC – Substance Abuse Rehabilitation Facility, NPI 1235787870

Sundance Behavioral Health LLC is a healthcare provider. based in West jordan, Utah. specializing in Substance Abuse Rehabilitation Facility. The NPI Number for Sundance Behavioral Health LLC is 1235787870

Main info

Organization
Name
Sundance Behavioral Health LLC
NPI
1235787870
Phone
Not provided
Address
7613 S JORDAN LANDING BLVD STE 200
Authorized Official
SIAMAK KHADJENOURY CEO
Enumeration Date
27 August 2019
Last Update Date
16 May 2023
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness80
Years active:6State licenses:0Digital endpointsUpdated within 12 months

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Provider Addresses for Sundance Behavioral Health LLC

  • Jordan Landing Boulevard, West Jordan, Salt Lake County, Utah, 84084, United States

    WEST JORDAN, UT 840841973

    Phone:

    Type: Mailing

  • 7181 S CAMPUS VIEW DR STE 1A

    WEST JORDAN, UT 840844312

    Phone:

    Type: Mailing

  • 7181 S CAMPUS VIEW DR

    WEST JORDAN, UT 840844312

    Phone: (425) 890-4777

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2021-03-22

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Revalidation scheduled

Earliest CMS due date is 2026-10-31 (144 days away).

Enrollment records

1

Earliest due date

2026-10-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20210322002445OClinic/Group PracticeUT2026-10-31

What to do next

  • Monitor the published due date as it approaches.
  • Plan to revalidate in PECOS within the window CMS allows before the due date.
  • Verify the date on the CMS Revalidation Lookup Tool before submitting.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 84084)

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Reviews

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Frequently asked questions

What federal number belongs to Sundance Behavioral Health LLC?
The federal identifier for Sundance Behavioral Health LLC is NPI 1235787870.
Is Sundance Behavioral Health LLC's NPI currently valid?
The extract we use shows Sundance Behavioral Health LLC as active.
What field does Sundance Behavioral Health LLC work in?
You can think of Sundance Behavioral Health LLC as practicing within Substance Abuse Rehabilitation Facility. Clinical services aligned with this taxonomy classification.
What location metadata exists for Sundance Behavioral Health LLC?
The page summarizes West Jordan, Utah for Sundance Behavioral Health LLC; expand the address list for detail.
How can I contact Sundance Behavioral Health LLC?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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