Provider Demographics
NPI:1528493152
Name:CATHOLIC COMMUNITY SERVICES REFUGEE
Entity type:Organization
Organization Name:CATHOLIC COMMUNITY SERVICES REFUGEE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:
Authorized Official - Last Name:OLIVAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-977-9119
Mailing Address - Street 1:745 E 300 S
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84102-2256
Mailing Address - Country:US
Mailing Address - Phone:801-977-9119
Mailing Address - Fax:
Practice Address - Street 1:745 E 300 S
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84102-2256
Practice Address - Country:US
Practice Address - Phone:801-977-9119
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-13
Last Update Date:2013-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management