Provider Demographics
NPI:1285708495
Name:LDS FAMILY SERVICES
Entity type:Organization
Organization Name:LDS FAMILY SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KEN
Authorized Official - Middle Name:G
Authorized Official - Last Name:LOWE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:435-673-6446
Mailing Address - Street 1:2202 N MAIN ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84720-9765
Mailing Address - Country:US
Mailing Address - Phone:435-586-4479
Mailing Address - Fax:
Practice Address - Street 1:2202 N MAIN ST
Practice Address - Street 2:SUITE 301
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84720-9765
Practice Address - Country:US
Practice Address - Phone:435-586-4479
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LDS FAMILY SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-20
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty