Provider Demographics
NPI:1174062590
Name:WEBER HUMAN SERVICES
Entity type:Organization
Organization Name:WEBER HUMAN SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMMUNITY HEALTH WORKER
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:JUDKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-686-0310
Mailing Address - Street 1:4820 S 350 E
Mailing Address - Street 2:APT A17
Mailing Address - City:WASHINGTON TERRACE
Mailing Address - State:UT
Mailing Address - Zip Code:84405
Mailing Address - Country:US
Mailing Address - Phone:801-686-0310
Mailing Address - Fax:
Practice Address - Street 1:4820 S 350 E
Practice Address - Street 2:APT A17
Practice Address - City:WASHINGTON TERRACE
Practice Address - State:UT
Practice Address - Zip Code:84405-6292
Practice Address - Country:US
Practice Address - Phone:801-686-0310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-17
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency