Provider Demographics
NPI:1497071419
Name:PERFETTO CLINICAL CONTRACTING, INC
Entity Type:Organization
Organization Name:PERFETTO CLINICAL CONTRACTING, INC
Other - Org Name:STARLIGHT PROGRAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:PERFETTO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:801-750-2224
Mailing Address - Street 1:345 E 4500 S
Mailing Address - Street 2:#260
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-3991
Mailing Address - Country:US
Mailing Address - Phone:801-750-2224
Mailing Address - Fax:801-747-2086
Practice Address - Street 1:345 E 4500 S
Practice Address - Street 2:#260
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-3991
Practice Address - Country:US
Practice Address - Phone:801-750-2224
Practice Address - Fax:801-747-2086
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PERFETTO CLINICAL CONTRACTING, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-04-15
Last Update Date:2010-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT15920253J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency