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Organization
OUR HOUSE OF PROVO
Active
Organization
OUR HOUSE OF PROVO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GENE SPAULDING (OWNER/MANAGER)
(801) 655-5090
Entity
Organization
Contact information
Practice address
462 S 900 E, PROVO, UT 84606-5234
(801) 655-5090
Mailing address
462 S 900 E, PROVO, UT 84606-5234
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
2012-ALII-106519
UT
Other
Enumeration date
08/27/2012
Last updated
08/27/2012
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