Organization
SOUTHERN UTAH UNIVERSITY
Active
Other names
Community & Family Health Services
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VERGEANIA P. DAVENPORT (PROGRAM MANAGER)
(435) 586-6070
Entity
Organization
Contact information
Practice address
2390 W HWY 56, STE 1, CEDAR CITY, UT 84720
(435) 586-6070
(435) 586-5232
Mailing address
PO BOX 142001, SALT LAKE CITY, UT 84114-2001
(435) 856-6070
(435) 586-5232
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
N/A
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8760000545631
—
UT
01
—
HT001413-001
PARTNER ID
UT
Enumeration date
09/27/2006
Last updated
06/26/2008
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