NPIMap

Organization Active NPI

Extended Family

  • Foster Care Agency
  • Spanish Fork, UT
National Provider Identifier
1285065607
Registry record updated Dec 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foster Care AgencyTaxonomy code 253J00000X
License
21187 Issued in UT
Legal business name
EXTENDED FAMILY
Practice address
704 N State Road 51
Spanish Fork, UT 84660-1385
Phone
(801) 794-0318
NPI assigned
Dec 11, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Terie Wiederhold
Title
Administrative Director
Phone
(801) 794-0318

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foster Care Agency 253J00000X 21187 UT Primary

Addresses

Primary practice location

704 N State Road 51
Spanish Fork, UT 84660-1385

Mailing address

704 N State Road 51
Spanish Fork, UT 84660-1385
Phone (801) 794-0318

National Provider Directory

National Provider Directory
Tax ID family
Extended Family2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1386720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386720000000",
    "number": "1285065607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 N STATE ROAD 51",
            "city": "SPANISH FORK",
            "state": "UT",
            "postal_code": "846601385",
            "telephone_number": "801-794-0318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 N STATE ROAD 51",
            "city": "SPANISH FORK",
            "state": "UT",
            "postal_code": "846601385",
            "telephone_number": "801-794-0318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXTENDED FAMILY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-11",
        "last_updated": "2013-12-11",
        "status": "A",
        "authorized_official_last_name": "WIEDERHOLD",
        "authorized_official_first_name": "TERIE",
        "authorized_official_title_or_position": "ADMINISTRATIVE DIRECTOR",
        "authorized_official_telephone_number": "801-794-0318"
    },
    "taxonomies": [
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": "UT",
            "license": "21187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spanish Fork, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.