Dallin Liddle
Foster Care Agency in Brigham City, UT. Individual provider (NPI-1).
NPI number1154630697
StatusActive
Last updated in NPPESOct 1, 2010
Details
- NPI
- 1154630697
- Entity type
- Individual (NPI-1)
- Name
- Mr. Dallin Liddle
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Oct 1, 2010
- Last updated
- Oct 1, 2010
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 253J00000X | Foster Care Agency | – | – | Yes |
Practice location
862 S Main StBrigham City, UT 84302-3320
Phone 435-723-1799
Mailing address
862 S Main StBrigham City, UT 84302-3320
Phone 435-723-1799
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 149 Foster Care Agency providers in Brigham City · All 997 providers in Brigham City
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