NPI 1558730218

Ddms of Utah No.2

Organisation Intellectual and/or Developmental Disabilities Residential Treatment Facility West Valley City, UT

Practice location

Address: 4028 S 4800 W, West Valley City, UT 84120-4537
Phone: (801) 968-8122
Fax: (801) 968-8135

Authorised official

Name: Misti Ann Buck
Title: Director of Operations
Phone: (801) 763-9299

Registered specialties

Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320600000X Licence 2015-SHCF-101 (UT)

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

Registry record

NPI: 1558730218
Entity type: Organization
NPI issued: 23 Sep 2015
Record last updated: 8 Jun 2023

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.