| NPI | 1730249053 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK RULON CORRY Administrator 435-619-0499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: UT 2005ALI9569) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2020-08-22 |