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Organization
TRINITY MISSION WIDE HORIZONS RESIDENTIAL CARE FACILITY, LP
Active
Organization
TRINITY MISSION WIDE HORIZONS RESIDENTIAL CARE FACILITY, LP
Active
Parent organization
COVENANT DOVE, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
COVENANT DOVE, LLC
Authorized official
MR. JUDY ULLERY (PRESIDENT)
(901) 937-7994
Entity
Organization
Contact information
Practice address
910 MONROE BLVD, OGDEN, UT 84404-6434
(801) 399-5876
(801) 392-2955
Mailing address
910 MONROE BLVD, OGDEN, UT 84404-6434
(801) 399-5876
(801) 392-2955
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
UTAH #2007-NCF-104
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
930947340014
—
UT
Enumeration date
05/16/2006
Last updated
04/10/2008
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