Provider Demographics
NPI:1538486931
Name:THE COVE
Entity Type:Organization
Organization Name:THE COVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:VERA
Authorized Official - Middle Name:E
Authorized Official - Last Name:CHRISTENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:801-774-8675
Mailing Address - Street 1:PO BOX 160276
Mailing Address - Street 2:
Mailing Address - City:CLEARFIELD
Mailing Address - State:UT
Mailing Address - Zip Code:84016-0276
Mailing Address - Country:US
Mailing Address - Phone:801-774-8675
Mailing Address - Fax:801-416-0862
Practice Address - Street 1:1105 S STATE ST
Practice Address - Street 2:
Practice Address - City:CLEARFIELD
Practice Address - State:UT
Practice Address - Zip Code:84015-1818
Practice Address - Country:US
Practice Address - Phone:801-774-8675
Practice Address - Fax:801-416-0862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-23
Last Update Date:2010-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1351643501253J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency