Organization
I CONNECTIONS SUPPORT COORDINATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL HAROLD IBARGUEN SSW (OWNER SUPPORT COORDINATOR)
(801) 663-9563
Entity
Organization
Contact information
Practice address
1905 S 575 E, CLEARFIELD, UT 84015-6230
(801) 728-0269
(801) 728-0269
Mailing address
1905 S 575 E, CLEARFIELD, UT 84015-6230
(801) 728-0269
(801) 728-0269
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
1028
UT
251B00000X
Case Management Agency
Primary
1033
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
204638051001
—
UT
Enumeration date
03/29/2007
Last updated
08/22/2020
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