Provider Demographics
NPI:1285968834
Name:SOUTHEASTERN UTAH ASSOCIATION OF LOCAL GOVERNMENTS
Entity type:Organization
Organization Name:SOUTHEASTERN UTAH ASSOCIATION OF LOCAL GOVERNMENTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:D
Authorized Official - Last Name:HOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-637-5444
Mailing Address - Street 1:375 S CARBON AVE
Mailing Address - Street 2:P.O. BOX 1106
Mailing Address - City:PRICE
Mailing Address - State:UT
Mailing Address - Zip Code:84501-2909
Mailing Address - Country:US
Mailing Address - Phone:435-637-5444
Mailing Address - Fax:435-637-5448
Practice Address - Street 1:375 S CARBON AVE
Practice Address - Street 2:
Practice Address - City:PRICE
Practice Address - State:UT
Practice Address - Zip Code:84501-2909
Practice Address - Country:US
Practice Address - Phone:435-637-5444
Practice Address - Fax:435-637-5448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT=========Medicaid