Organization
TKJ LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES QUE JENSEN LCSW (EXECUTIVE DIRECTOR)
(801) 943-1860
Entity
Organization
Contact information
Practice address
2413 ROYAL LN, SANDY, UT 84093-6453
(801) 943-1860
(801) 942-5094
Mailing address
2413 ROYAL LN, SANDY, UT 84093-6453
(801) 943-1860
(801) 942-5094
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
11803
UT
Other
Enumeration date
01/03/2007
Last updated
12/10/2008
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