| NPI | 1487167805 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK R JACKMAN Owner 435-275-4458 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: UT 000820) |
| Enumeration Date | 2017-11-07 |
| Last Update Date | 2017-11-07 |