Provider Demographics
NPI:1043961121
Name:UTAH COUNTY PUBLIC DEFENDER ASSOCIATION
Entity type:Organization
Organization Name:UTAH COUNTY PUBLIC DEFENDER ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:LOGAN
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:801-592-8547
Mailing Address - Street 1:180 N UNIVERSITY AVE STE 140
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84601-5940
Mailing Address - Country:US
Mailing Address - Phone:801-592-8547
Mailing Address - Fax:
Practice Address - Street 1:180 N UNIVERSITY AVE STE 140
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84601-5940
Practice Address - Country:US
Practice Address - Phone:801-592-8547
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-11
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management