| NPI | 1114289980 |
|---|---|
| Former Legal Business Name | INTERMOUNTAIN SENIOR CARE, LLC |
| Entity Type | Organization |
| Authorized Contact | CLIFF HOLT Owner 435-628-8944 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health |
| Enumeration Date | 2012-06-08 |
| Last Update Date | 2021-05-03 |