Provider Demographics
NPI:1326159948
Name:FRONT LINE SERVICES, INC.
Entity Type:Organization
Organization Name:FRONT LINE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RICK
Authorized Official - Middle Name:
Authorized Official - Last Name:MEMMOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-746-3077
Mailing Address - Street 1:PO BOX 57456
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84157-0456
Mailing Address - Country:US
Mailing Address - Phone:801-746-3077
Mailing Address - Fax:801-282-0304
Practice Address - Street 1:1800 S WEST TEMPLE
Practice Address - Street 2:SUITE A110
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84115-1851
Practice Address - Country:US
Practice Address - Phone:801-746-3077
Practice Address - Fax:801-282-0304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10216261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)