Provider Demographics
NPI:1841611365
Name:SALT LAKE COUNTY CRIMINAL JUSTICE SERVICES
Entity Type:Organization
Organization Name:SALT LAKE COUNTY CRIMINAL JUSTICE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREATMENT SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ROWE
Authorized Official - Suffix:
Authorized Official - Credentials:CSW
Authorized Official - Phone:385-468-3529
Mailing Address - Street 1:145 E 1300 S
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84115-5482
Mailing Address - Country:US
Mailing Address - Phone:385-468-3529
Mailing Address - Fax:
Practice Address - Street 1:145 E 1300 S
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84115-5482
Practice Address - Country:US
Practice Address - Phone:385-468-3529
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-31
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty