Provider Demographics
NPI:1396906962
Name:PLACES IN THE HEART, INC
Entity type:Organization
Organization Name:PLACES IN THE HEART, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:E
Authorized Official - Last Name:HAWS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LCSW
Authorized Official - Phone:801-809-3048
Mailing Address - Street 1:881 S OREM BLVD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84058-5033
Mailing Address - Country:US
Mailing Address - Phone:801-809-3048
Mailing Address - Fax:801-224-7808
Practice Address - Street 1:881 S OREM BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84058-5033
Practice Address - Country:US
Practice Address - Phone:801-809-3048
Practice Address - Fax:801-224-7808
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PLACES IN THE HEART, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-06-17
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT56615813501302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization