Provider Demographics
NPI:1891140331
Name:CARING FOR KEARNS
Entity Type:Organization
Organization Name:CARING FOR KEARNS
Other - Org Name:CARING FOR KEARNS COMMUNITY
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:801-680-3255
Mailing Address - Street 1:5525 S 4015 W
Mailing Address - Street 2:SUITE #207 A & B
Mailing Address - City:TAYLORSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84129
Mailing Address - Country:US
Mailing Address - Phone:801-680-3255
Mailing Address - Fax:
Practice Address - Street 1:5525 S 4015 W
Practice Address - Street 2:SUITE #207 A & B
Practice Address - City:TAYLORSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84129
Practice Address - Country:US
Practice Address - Phone:801-680-3255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-03
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT34753135011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty