Organization
KEY RESIDENTIAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH E EKONG MSW (EXECUTIVE DIRECTOR)
(801) 360-6357
Entity
Organization
Contact information
Practice address
1361 S 740 E, OREM, UT 84097-8083
(801) 434-4389
(801) 434-4391
Mailing address
3322 MONTE VERDE DR, SALT LAKE CITY, UT 84109-3227
(801) 360-6357
(801) 434-4391
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
UT
Other
Enumeration date
03/30/2007
Last updated
08/22/2020
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