Provider Demographics
NPI:1730116880
Name:FAMILY ENRICHMENT CENTER DAVIS SCHOOL DISTRICT
Entity Type:Organization
Organization Name:FAMILY ENRICHMENT CENTER DAVIS SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:SARTOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-402-0652
Mailing Address - Street 1:320 S 500 E
Mailing Address - Street 2:
Mailing Address - City:KAYSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84037
Mailing Address - Country:US
Mailing Address - Phone:801-402-0669
Mailing Address - Fax:801-402-0651
Practice Address - Street 1:320 S 500 E
Practice Address - Street 2:
Practice Address - City:KAYSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84037-3307
Practice Address - Country:US
Practice Address - Phone:801-402-0669
Practice Address - Fax:801-402-0651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-26
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT=========645Medicaid