Utah State Developmental Center

NPI 1689674301 - Intermediate Care Facility, Mental Illness - 310500000X

NPI Details
NPI 1689674301
Enumeration Date 07/22/2005
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 11 years ago
Authorized Information
Name KAREN KAREN
Position SUPERINTENDENT
Phone (801) 763-4000
Fax (801) 763-4073
Practice Location
895 N. 900 E.
AMERICAN FORK UT, 84003-9199, US
Phone (801) 763-4000
Fax (801) 763-4073
Business Location
895 N. 900 E.
AMERICAN FORK UT, 84003-9199, US
Phone (801) 763-4000
Fax (801) 763-4073
Toxanomy
Taxonomy Code 310500000X
License State Utah
License Number 2004-NCF-95
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According to our database, Utah State Developmental Center NPI is 1689674301, taxonomy code is 310500000X and license number is 2004-NCF-95, license state is located at Utah. Utah State Developmental Center physically located at 895 N. 900 E., American Fork UT, 84003-9199. NPI Number 1033115704 has the healthcare provider type.

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1689674301 NPI number is provided on an as is basis without warranty of any kind. 1689674301 is maintained by the National Plan & Provider Enumeration System. The contents of Utah State Developmental Center are for informational purposes only.