Organization
RHA COMMUNITY SERVICES OF UTAH
Active
Other names
Bungalow Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
JACKLYNN IVY HUGHES (ADMINISTRATOR)
(801) 582-8097
Entity
Organization
Contact information
Practice address
645 S 1300 E, SALT LAKE CITY, UT 84102-3206
(801) 582-1457
(801) 582-3901
Mailing address
645 S 1300 E, SALT LAKE CITY, UT 84102-3206
(801) 582-1457
(801) 582-3901
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
2004-NCF-22
UT
Other
Enumeration date
07/26/2005
Last updated
08/22/2020
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