Organization
SUCCESSOR HEALTHCARE LLC
Active
Other names
St. Joseph Villa
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SOON BURNAM (TREASURER OF MANAGEMENT COMPANY)
(949) 540-1249
Entity
Organization
Contact information
Practice address
451 BISHOP FEDERAL LN, SALT LAKE CITY, UT 84115-2357
(801) 487-7557
(801) 487-1112
Mailing address
451 BISHOP FEDERAL LN, SALT LAKE CITY, UT 84115-2357
(801) 487-7557
(801) 487-1112
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
—
UT
314000000X
Skilled Nursing Facility
Primary
—
UT
Other
Enumeration date
12/21/2010
Last updated
06/03/2016
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