NPI | 1225564826 |
---|---|
Entity Type | Organization |
Authorized Contact | MARK R JOHNSON Provider 801-631-8210 |
Organization Subpart ? | No |
Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: UT 184901-1205) |
Additional Taxonomies | 310400000X Assisted Living Facility (Licence: UT 184901-1205) |
Enumeration Date | 2017-05-03 |
Last Update Date | 2017-05-03 |