Extended Family, Inc.

LBN: Extended Family, Inc.
Extended Family, Inc. is an health care organization with primary practice located at 704 N State Road 51 , Spanish Fork UT 84660-1385. The organization recently has only one registered license in Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children, which is considered as the primary health care specialty. Extended Family, Inc. can be contacted via phone (801) 794-0318, or through Wiederhold, Paul via phone (801) 794-0318.

Contact Information

Primary practice address
704 N State Road 51 Spanish Fork UT 84660-1385
Phone: (801) 794-0318
Fax: (801) 794-9514
Website:
Map and Directions
Authorized official contact:
Name: Wiederhold, Paul PH.D.
Phone: (801) 794-0318

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children 322D00000X 12040 Utah

Profile Details

NPI number 1215068267
LBN Legal business name Extended Family, Inc.
DBA Doing business as
Authorized official Wiederhold, Paul PH.D.
Entity Organization
Organization subpart 1 No
Enumeration date Mar 8th, 2007
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215068267 NPPES
Utah MEDICAID 788007788033

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