Healthcare Provider Details

I. General information

NPI: 1407749880
Provider Name (Legal Business Name): MALOUF FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2025
Last Update Date: 06/02/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

331 S RIO GRANDE ST STE 303
SALT LAKE CITY UT
84101-1125
US

IV. Provider business mailing address

331 S RIO GRANDE ST STE 303
SALT LAKE CITY UT
84101-1125
US

V. Phone/Fax

Practice location:
  • Phone: 435-503-4463
  • Fax:
Mailing address:
  • Phone: 435-503-4463
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: WHITNEY JULKUNEN
Title or Position: JUNIPER PROGRAM DIRECTOR
Credential: LCSW
Phone: 801-382-7202