Organization
THE ROAD HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LESLIE S. RUSSELL MSW (DIRECTOR OF HUMAN RESOURCES/GRANTS)
(801) 355-9391
Entity
Organization
Contact information
Practice address
210 S RIO GRANDE ST, SALT LAKE CITY, UT 84101-1104
(801) 355-9391
(801) 359-8254
Mailing address
210 S RIO GRANDE ST, SALT LAKE CITY, UT 84101-1104
(801) 355-9391
(801) 359-8254
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
133036-3502
UT
Other
Enumeration date
09/07/2006
Last updated
08/22/2020
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