NPI | 1073991410 |
---|---|
Entity Type | Organization |
Authorized Contact | RONALD RAYMOND TRUDEL President 801-891-9313 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: UT 4866189-1205) |
Additional Taxonomies | 253Z00000X In Home Supportive Care (Licence: UT 4866189-1205) |
Enumeration Date | 2015-05-18 |
Last Update Date | 2020-10-28 |