NPI | 1063882710 |
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Doing Business As | BUNGALOW CARE CENTER |
Entity Type | Organization |
Authorized Contact | CHRISTINE L CHRISTENSEN Director Of Operations 801-763-9299 |
Organization Subpart ? | No |
Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: UT 2015-NCF-22) |
Enumeration Date | 2015-10-06 |
Last Update Date | 2015-10-06 |