| Organization Name: | J MANUEL DE LA TORRE INC |
| NPI Number: | 1164586061 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JESUS MANUEL DE LA TORRE (PRESIDENT OWNER) |
| Mailing Address: | 1579 W 6005 Slc |
| State: | UT US |
| Postal Code: | 841042512 |
| Phone Number: | 8019730655 |
| Fax Number: | 8019730655 |
| NPI Enumeration Date: | 12/22/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 1315073501 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |