| NPI | 1457721789 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORGE GUSTAVO GONZALEZ Administrator 801-753-9130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: UT 2015-ALI-UT207199) |
| Enumeration Date | 2015-09-29 |
| Last Update Date | 2015-09-29 |