Organization
ANGELS CROSSING HOME HOSPICE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MAILE SUE TAVAKE REGISTERED NURSE (MEMBER)
(801) 428-1060
Entity
Organization
Contact information
Practice address
2480 S MAIN ST, SUITE 200, SALT LAKE CITY, UT 84115-3058
(801) 428-1060
(801) 855-5908
Mailing address
2480 S MAIN ST, SUITE 200, SALT LAKE CITY, UT 84115-3058
(801) 428-1060
(801) 855-5908
Taxonomy
Speciality
Code
Description
License number
State
315D00000X
Inpatient Hospice
Primary
—
—
Other
Enumeration date
08/27/2008
Last updated
05/07/2018
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