Provider Demographics
NPI:1730234733
Name:EATON ALLIANCE, INC.
Entity type:Organization
Organization Name:EATON ALLIANCE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:THUESON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-455-6485
Mailing Address - Street 1:PO BOX 97
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-0097
Mailing Address - Country:US
Mailing Address - Phone:801-768-0608
Mailing Address - Fax:801-766-8541
Practice Address - Street 1:9710 S 700 E
Practice Address - Street 2:111
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84070-3594
Practice Address - Country:US
Practice Address - Phone:801-768-0608
Practice Address - Fax:801-766-8541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UTA00910320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities