Healthcare Provider Details

I. General information

NPI: 1982903209
Provider Name (Legal Business Name): UTAH KIDS FIRST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2011
Last Update Date: 03/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 E 9670 S
SANDY UT
84070-3331
US

IV. Provider business mailing address

205 E 9670 S
SANDY UT
84070-3331
US

V. Phone/Fax

Practice location:
  • Phone: 801-790-4516
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number17615
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number17616
License Number StateUT

VIII. Authorized Official

Name: LACEY RAMIREZ
Title or Position: PROGRAM DIRECTOR
Credential:
Phone: 801-790-4516