Organization
BEAVER VALLEY HOSPITAL
Active
Other names
Cascades at Riverwalk
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD FULLMER MPT (MANAGING PARTNER)
(801) 635-6602
Entity
Organization
Contact information
Practice address
1012 W JORDAN RIVER BLVD, MIDVALE, UT 84047
(801) 565-0800
Mailing address
1012 W JORDAN RIVER BLVD, MIDVALE, UT 84047
(801) 565-0800
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2015-NCF UT000664
UTAH DEPT OF HEALTH
UT
05
—
461003359001
—
UT
Enumeration date
07/11/2014
Last updated
07/31/2017
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