Organization
LEGACY HEALTHCARE OF LAYTON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL FAIRHOLM (OWNER)
(801) 269-0700
Entity
Organization
Contact information
Practice address
1203 N FAIRFIELD RD, LAYTON, UT 84041-8321
(801) 927-5927
(801) 927-6235
Mailing address
1203 N FAIRFIELD RD, LAYTON, UT 84041-8321
(801) 927-5927
(801) 927-6235
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
264368361001
—
UT
Enumeration date
03/09/2010
Last updated
07/11/2012
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