Organization
RHA HEALTH SERVICE UT LLC
Active
Other names
Bungalow Care center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHRISTINE L CHRISTENSEN (DIRECTOR OF OPERATIONS)
(801) 763-9299
Entity
Organization
Contact information
Practice address
645 S 1300 E, SALT LAKE CITY, UT 84102
(801) 582-1457
(801) 582-3901
Mailing address
119 S PACIFIC DR #109, AMERICAN FORK, UT 84003
(801) 763-9299
(801) 763-1121
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
2015-NCF-22
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2015-NCF-22
—
UT
Enumeration date
10/06/2015
Last updated
10/06/2015
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