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Organization

LDS FAMILY SERVICES

Active
Parent organization
LDS FAMILY SERVICES
Other names
LDS Family Services UT Provo Agency
Organization subpart
Yes

Provider details

NPI number
Legal business name
LDS FAMILY SERVICES
Authorized official
SHAWN A GILLIES LCSW (AGENCY DIRECTOR)
(801) 422-7620
Entity
Organization

Contact information

Practice address
1190 N 900 E, 204, PROVO, UT 84604-3536
(801) 422-7620
(801) 422-0165
Mailing address
1190 N 900 E, 204, PROVO, UT 84604-3536
(801) 422-7620
(801) 422-0165

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
12208
UT

Other

Enumeration date
04/24/2007
Last updated
06/06/2008
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