Organization
SATL LAKE COUNTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KARI LARSEN SSW (CASE MANGER)
(385) 468-4519
Entity
Organization
Contact information
Practice address
177 W PRICE AVE, SALT LAKE CITY, UT 84115-4345
(385) 468-4500
Mailing address
177 W PRICE AVE, SALT LAKE CITY, UT 84115-4345
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
57480656-3503
UT
Other
Enumeration date
05/08/2013
Last updated
05/13/2013
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