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Organization
CARESOURCE L L C
Active
Organization
CARESOURCE L L C
Active
Other names
CareSource Home Health
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHAWNTEL TANNER MA (ADMINISTRATOR)
(801) 266-7200
Entity
Organization
Contact information
Practice address
750 KEARNS BLVD # 200, PARK CITY, UT 84060-5137
(801) 266-7200
(801) 266-7004
Mailing address
PO BOX 680839, PARK CITY, UT 84068-0839
(801) 266-7200
(801) 266-7004
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
2006-HHA-912
UT
Other
Enumeration date
04/12/2007
Last updated
11/14/2016
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