| NPI | 1669130159 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BROOKE HIXSON Controller 801-601-1450 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Additional Taxonomies | 313M00000X Nursing Facility/Intermediate Care Facility |
| Enumeration Date | 2021-12-02 |
| Last Update Date | 2022-05-12 |