Provider Demographics
NPI:1982633145
Name:WEBER-MORGAN EARLY INTERVENTION
Entity Type:Organization
Organization Name:WEBER-MORGAN EARLY INTERVENTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM COORDINATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ORVIL
Authorized Official - Middle Name:J
Authorized Official - Last Name:STOKES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-476-5460
Mailing Address - Street 1:955 W 12TH ST
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84404-5409
Mailing Address - Country:US
Mailing Address - Phone:801-476-5460
Mailing Address - Fax:
Practice Address - Street 1:955 W 12TH ST
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84404-5409
Practice Address - Country:US
Practice Address - Phone:801-476-5460
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
N/A251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT=========520Medicaid