| NPI | 1376814160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATT RASBAND Manager 801-683-9550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: UT 2012-ALII-87810) |
| Additional Taxonomies | 385H00000X Respite Care (Licence: UT 2012-ALII-87810) |
| Enumeration Date | 2012-01-25 |
| Last Update Date | 2012-01-25 |