OrganizationActive
Extended Family Boys, Inc.
NPI 1689986457 · Emotionally Disturbed Childrens' Residential Treatment Facility · Spanish Fork, UT
Provider details
- NPI number
- 1689986457
- Entity type
- Organization
- Primary specialty
- Emotionally Disturbed Childrens' Residential Treatment FacilityResidential Treatment Facilities
- Authorized official
- Terie Wiederhold, Administrative Director
Practice location
704 N State Road 51
Spanish Fork, UT 84660-1385
Phone: (801) 794-0318
Fax: (801) 794-9514
Mailing address
704 N State Road 51
Spanish Fork, UT 84660-1385
Registry dates
- Enumerated
- 2010-07-09
- Last updated
- 2010-07-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.