Organization
CEREBRAL PALSY OF UTAH
Active
Organization
CEREBRAL PALSY OF UTAH
Active
Other names
Foundations for Independence
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHELLY G PETTY (EXECUTIVE DIRECTOR)
(801) 266-1805
Entity
Organization
Contact information
Practice address
3550 S 700 W, SALT LAKE CITY, UT 84119-4120
(801) 266-1805
(801) 266-2404
Mailing address
3550 S 700 W, SALT LAKE CITY, UT 84119-4120
(801) 266-1805
(801) 266-2404
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
—
UT
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
UT
Other
Enumeration date
12/19/2006
Last updated
09/02/2010
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