Healthcare Provider Details

I. General information

NPI: 1225340656
Provider Name (Legal Business Name): SAI, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2010
Last Update Date: 07/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2480 S MAIN ST SUITE 105
SALT LAKE CITY UT
84115-3058
US

IV. Provider business mailing address

2480 S MAIN ST SUITE 105
SALT LAKE CITY UT
84115-3058
US

V. Phone/Fax

Practice location:
  • Phone: 801-485-3772
  • Fax: 801-485-3750
Mailing address:
  • Phone: 801-485-3772
  • Fax: 801-485-3750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number16782
License Number StateUT

VIII. Authorized Official

Name: MR. SIONE TAVAKE
Title or Position: EX. DIRECTOR.
Credential:
Phone: 801-485-3772