| NPI | 1558513812 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY LYMAN CEO 435-678-3993 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC0050X Clinic/Center, Critical Access Hospital (Licence: UT 2011-HOSP-96389) |
| Additional Taxonomies | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment (Licence: UT 2010-ESRD-90350) |
| 275N00000X Medicare Defined Swing Bed Unit | |
| Enumeration Date | 2008-10-17 |
| Last Update Date | 2023-09-19 |