Provider Demographics
NPI:1598076598
Name:CHILD & FAMILY EMPOWERMENT SERVICES LLC
Entity Type:Organization
Organization Name:CHILD & FAMILY EMPOWERMENT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LANI
Authorized Official - Middle Name:
Authorized Official - Last Name:TAHOLO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:801-972-2711
Mailing Address - Street 1:1578 W 1700 S STE 103
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84104-3490
Mailing Address - Country:US
Mailing Address - Phone:801-972-2711
Mailing Address - Fax:
Practice Address - Street 1:1578 W 1700 S STE 103
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84104-3490
Practice Address - Country:US
Practice Address - Phone:801-972-2711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-24
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1332463501253J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency