Organization
AGTECH4VETS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE IVERSON (MANAGER)
(202) 569-2990
Entity
Organization
Contact information
Practice address
1883 WEST ROYAL HUNTE DR STE 200A, CEDAR CITY, UT 84720-4000
(855) 772-3374
(855) 483-2771
Mailing address
1883 WEST ROYAL HUNTE DR STE 200A, CEDAR CITY, UT 84720-4000
(855) 772-3374
(855) 483-2771
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
06/20/2023
Last updated
06/20/2023
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