| NPI | 1700495496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BROOKE HIXSON Controller 801-601-1450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist, | |
| 261Q00000X Clinic/Center | |
| 261QH0700X Clinic/Center, Hearing and Speech | |
| 261QP2000X Clinic/Center, Physical Therapy | |
| 261QX0100X Clinic/Center, Occupational Medicine | |
| Enumeration Date | 2020-07-28 |
| Last Update Date | 2023-06-19 |