Organization
NORTH EASTERN SERVICES - LAKESIDE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CORY CRABB (EXECUTIVE DIRECTOR)
(801) 830-1063
Entity
Organization
Contact information
Practice address
443 COMMERCE RD, OREM, UT 84058-5898
(801) 426-4961
Mailing address
529 W 300 S, OREM, UT 84058-5398
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
5668189-0142
UT
Other
Enumeration date
03/30/2007
Last updated
08/22/2020
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