| NPI | 1578517546 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRAIG R JOHNSON Sec / Treasurer 801-268-1122 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: UT 2005-NCF-32) |
| Additional Taxonomies | 332BN1400X Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies (Licence: UT 2007-NCF-32) |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: UT 2007-NCF-32) | |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2008-04-20 |