NPI 1164542379

Key Residential Services

Organisation Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Orem, UT

Practice location

Address: 1361 S 740 E, Orem, UT 84097-8083
Phone: (801) 434-4389
Fax: (801) 434-4391
Mailing address: 3322 Monte Verde Dr, Salt Lake City, UT 84109-3227

Authorised official

Name: Kenneth E Ekong
Title: Executive Director
Phone: (801) 360-6357

Registered specialties

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320900000X

Other Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in Utah →

Registry record

NPI: 1164542379
Entity type: Organization
NPI issued: 30 Mar 2007
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.