Provider Demographics
NPI:1922410372
Name:OAKGROVE SCHOOL INC.
Entity Type:Organization
Organization Name:OAKGROVE SCHOOL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF HUMAN RESOURCE AND FINA
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:DIMICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-621-3901
Mailing Address - Street 1:1325 WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84404-5744
Mailing Address - Country:US
Mailing Address - Phone:801-399-1402
Mailing Address - Fax:801-399-1765
Practice Address - Street 1:3375 HARRISON BLVD
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403-1228
Practice Address - Country:US
Practice Address - Phone:801-621-3901
Practice Address - Fax:801-621-3991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-20
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UTSTATE LICENSE 5274251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTN31263OtherTAX EXEMPT NUMBER