Healthcare Provider Details

I. General information

NPI: 1770414740
Provider Name (Legal Business Name): COMUNIDAD MATERNA EN UTAH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 E 5600 S STE 307
MURRAY UT
84107-8128
US

IV. Provider business mailing address

141 E 5600 S STE 307
MURRAY UT
84107-8128
US

V. Phone/Fax

Practice location:
  • Phone: 801-920-3285
  • Fax:
Mailing address:
  • Phone: 801-920-3285
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name: MAYRA ABISH SANCHEZ
Title or Position: ED
Credential:
Phone: 801-920-3285