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Organization
HHALMID
Active
Organization
HHALMID
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLI PARDOE (ADMINISTRATOR)
(801) 910-9821
Entity
Organization
Contact information
Practice address
6968 S 700 E, MIDVALE, UT 84047
(801) 910-9821
Mailing address
6968 S 700 E, MIDVALE, UT 84047
(801) 910-9821
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5300233603
—
UT
Enumeration date
05/15/2018
Last updated
05/18/2018
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