| NPI | 1922864982 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDRE SAM Executive Director 801-884-9684 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3747P1801X Technician Personal Care Attendant |
| Additional Taxonomies | 251X00000X Supports Brokerage |
| 253Z00000X In Home Supportive Care | |
| 372600000X Adult Companion | |
| 3747A0650X Technician Attendant Care Provider | |
| 376J00000X Homemaker | |
| 385HR2060X Respite Care Respite Care, Mental Retardation and/or Developmental Disabilities | |
| 385HR2065X Respite Care Respite Care, Physical Disabilities, Child | |
| Enumeration Date | 2024-02-26 |
| Last Update Date | 2024-02-26 |