Organization
KOSTOPULOS DREAM FOUNDATION
Active
Other names
Camp Kostopulos
Organization subpart
No
Provider details
NPI number
Authorized official
GARY ETHINGTON (EXECUTIVE DIRECTOR)
(801) 582-0700
Entity
Organization
Contact information
Practice address
2500 EMIGRATION CYN, SALT LAKE CITY, UT 84108-1517
(801) 582-0700
(801) 583-5176
Mailing address
2500 EMIGRATION CYN, SALT LAKE CITY, UT 84108-1517
(801) 582-0700
(801) 583-5176
Taxonomy
Speciality
Code
Description
License number
State
385HR2050X
Respite Care Camp
Primary
C126
UT
Other
Enumeration date
01/02/2007
Last updated
08/22/2020
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