| NPI | 1487719662 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELVIN DARCY FORSMAN Owner 801-272-2601 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: UT 2919) |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2020-08-22 |