| NPI | 1457354755 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN CHAVIS Administrator 801-355-9649 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: UT 2004-NCF-36877) |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2020-08-22 |