Provider Demographics
NPI:1588841514
Name:DISABLED RIGHTS ACTION COMMITTEE
Entity Type:Organization
Organization Name:DISABLED RIGHTS ACTION COMMITTEE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:COSTLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:801-347-0370
Mailing Address - Street 1:3565 S WEST TEMPLE
Mailing Address - Street 2:SUITE 16
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84115-4493
Mailing Address - Country:US
Mailing Address - Phone:801-685-8214
Mailing Address - Fax:801-685-8216
Practice Address - Street 1:3565 S WEST TEMPLE
Practice Address - Street 2:SUITE 16
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84115-4493
Practice Address - Country:US
Practice Address - Phone:801-685-8214
Practice Address - Fax:801-685-8216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-22
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable