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Organization
PROVO CARE CENTER
Active
Organization
PROVO CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CATHERINE LYN PLANT B.S. (ADMINISTRATOR)
(180) 373-8771
Entity
Organization
Contact information
Practice address
256 E CENTER ST, PROVO, UT 84606-3107
(180) 137-3877
(180) 137-3326
Mailing address
PO BOX 1933, 256 EAST CENTER STREET, PROVO, UT 84603-1933
(180) 137-3877
(180) 137-3326
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
2004-NCF-79
UT
Other
Enumeration date
07/19/2005
Last updated
08/22/2020
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