Organization
DDI VANTAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER C KELSEY (EXECUTIVE DIRECTOR)
(801) 266-3979
Entity
Organization
Contact information
Practice address
565 EAST 4500 SOUTH, STE 4220, SALT LAKE CITY, UT 84107
(801) 233-3979
(801) 270-8587
Mailing address
565 EAST 4500 SOUTH, STE 4220, SALT LAKE CITY, UT 84107
(801) 233-3979
(801) 270-8587
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
09/11/2006
Last updated
03/23/2021
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