Healthcare Provider Details

I. General information

NPI: 1104032317
Provider Name (Legal Business Name): VALLEY PERSONNEL SERVICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1368 W 130 S
OREM UT
84058-5136
US

IV. Provider business mailing address

1368 W 130 S
OREM UT
84058-5136
US

V. Phone/Fax

Practice location:
  • Phone: 801-226-4411
  • Fax: 801-426-9731
Mailing address:
  • Phone: 801-226-4411
  • Fax: 801-426-9731

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number0350
License Number StateUT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0350
Identifier TypeOTHER
Identifier StateUT
Identifier IssuerDSPD

VIII. Authorized Official

Name: MRS. HELLEN H JOHNSON
Title or Position: EXT DRICTER
Credential:
Phone: 801-226-4411