COUNTRY NICHE ADULT DAY CARE — NPI 1780067785 (Licensed & Credentialed Respite Care in CLINTON, UT)

CMS-1500 Box 24J / 33a • NPI

1780067785

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

385H00000X

Licensed & Credentialed Respite Care

Box 32 Service Location & ZIP+4

2179 W 1800 N STE D, CLINTON, UT, 84015-7900

✓ 9-Digit EDI 837 ZIP+4 (84015-7900)

Practice Phone & Referral Fax

(801) 436-5727

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1780067785 (COUNTRY NICHE ADULT DAY CARE) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1780067785` (NPI-2 Organization / Facility)
Provider / Legal Name	COUNTRY NICHE ADULT DAY CARE
Plain-English Specialty	Licensed & Credentialed Respite Care NUCC Code: `385H00000X` (Respite Care)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	2179 W 1800 N STE D, CLINTON, UT, 84015-7900
Practice Telephone / Fax	Tel: (801) 436-5727
Administrative Mailing Address	PO BOX 150493, OGDEN, UT, 84415-0493
Enumeration & Last Sync	Enumerated: 2015-07-08 \| CMS Record Updated: 2015-07-08
Authorized Official	JENNIE FRY (Owner)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

2179 W 1800 N STE D, CLINTON, UT, 84015-7900

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Plain-English Taxonomy & CMS Crosswalk (385H00000X)

What Does Taxonomy Code 385H00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 385H00000X translates to:
"Licensed & Credentialed Respite Care"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Respite Care for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (COUNTRY NICHE ADULT DAY CARE)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`385H00000X` — Respite Care Plain English: Licensed & Credentialed Respite Care	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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COUNTRY NICHE ADULT DAY CARE (NPI #1780067785)