Provider Demographics
NPI:1003542929
Name:UTAH SENTINEL SERVICES
Entity Type:Organization
Organization Name:UTAH SENTINEL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TYLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:WEIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-380-4949
Mailing Address - Street 1:640 E CENTER ST
Mailing Address - Street 2:
Mailing Address - City:LINDON
Mailing Address - State:UT
Mailing Address - Zip Code:84042-2129
Mailing Address - Country:US
Mailing Address - Phone:801-380-4949
Mailing Address - Fax:
Practice Address - Street 1:640 E CENTER ST
Practice Address - Street 2:
Practice Address - City:LINDON
Practice Address - State:UT
Practice Address - Zip Code:84042-2129
Practice Address - Country:US
Practice Address - Phone:801-380-4949
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-25
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child