Provider Demographics
NPI:1194910133
Name:CEFIA ENTERPRISES INCORPORATED
Entity type:Organization
Organization Name:CEFIA ENTERPRISES INCORPORATED
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CEDRIC
Authorized Official - Middle Name:DELEON
Authorized Official - Last Name:PITTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:801-282-6953
Mailing Address - Street 1:PO BOX 9034
Mailing Address - Street 2:
Mailing Address - City:CHANDLER HEIGHTS
Mailing Address - State:AZ
Mailing Address - Zip Code:85127-9034
Mailing Address - Country:US
Mailing Address - Phone:702-743-1269
Mailing Address - Fax:801-855-7215
Practice Address - Street 1:217 E SCENIC PEAK CV
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-9222
Practice Address - Country:US
Practice Address - Phone:801-282-6953
Practice Address - Fax:801-855-7215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-12
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NVGF1254016640001322D00000X
UT19995322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty