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NPI Code Detail

MEDICARE: JOANN BARILE

MEDICARE: JOANN BARILE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1253J00000XFoster Care Agency

General Provider Information

NPI Number : 1316236268
Entity Type Code : Organization
Provider Name (Legal Business Name) : JOANN BARILE
Provider Business Mailing Address
First Line : 2866 PINGREE AVENUE
Second Line :
City : OGDEN
State : UT
Zip : 84401-3522
Country : US
Telephone Number : 801-648-5121
Fax Number :
Provider Business Practice Location Address
First Line : 3742 W 4000 S
Second Line :
City : WEST HAVEN
State : UT
Zip : 84401-9630
Country : US
Telephone Number : 801-731-0426
Fax Number :
Authorized Official
Title or Position : PROGRAM DIRECTOR
Name : MR. JOSE BARELA
Credential :
Telephone Number : 801-731-0426
Provider Enumeration Date : 03/31/2011
Last Update Date : 03/31/2011

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