Organization
EXTENDED FAMILY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL WIEDERHOLD PH.D. (EXECUTIVE DIRECTOR)
(801) 794-0318
Entity
Organization
Contact information
Practice address
704 N STATE ROAD 51, SPANISH FORK, UT 84660-1385
(801) 794-0318
(801) 794-9514
Mailing address
704 N STATE ROAD 51, SPANISH FORK, UT 84660-1385
(801) 794-0318
(801) 794-9514
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
12040
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
788007788033
—
UT
Enumeration date
03/08/2007
Last updated
08/22/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us