Provider Demographics
NPI:1871641449
Name:FAMILY MATTERS SERVICES INC
Entity Type:Organization
Organization Name:FAMILY MATTERS SERVICES INC
Other - Org Name:FAMILY MATTERS SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORPORATE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JACKIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:WALTERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-628-7355
Mailing Address - Street 1:1604 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-8335
Mailing Address - Country:US
Mailing Address - Phone:801-771-7020
Mailing Address - Fax:801-771-7003
Practice Address - Street 1:1604 CHURCH ST
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-8335
Practice Address - Country:US
Practice Address - Phone:801-771-7020
Practice Address - Fax:801-771-7003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT320900000XMedicaid
UT163W00000XMedicaid
UT372500000XMedicaid
UT372600000XMedicaid