Provider Demographics
NPI:1679330070
Name:GOGIVERS FAMILY SERVICES LLC
Entity type:Organization
Organization Name:GOGIVERS FAMILY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ELENOA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-403-0033
Mailing Address - Street 1:2455 E PARLEYS WAY STE 220
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84109-1252
Mailing Address - Country:US
Mailing Address - Phone:801-403-0033
Mailing Address - Fax:
Practice Address - Street 1:2455 E PARLEYS WAY STE 220
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84109-1252
Practice Address - Country:US
Practice Address - Phone:801-403-0033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-01
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamilyGroup - Multi-Specialty
No103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysisGroup - Multi-Specialty
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Multi-Specialty