Organization
COUNTRY NICHE ADULT DAY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL ALLEN BURNETT (OWNER)
(801) 825-3582
Entity
Organization
Contact information
Practice address
2179 W 1800 N, SUITE D, CLINTON, UT 84015-7900
(801) 825-3582
(801) 825-8536
Mailing address
2179 W 1800 N, SUITE D, CLINTON, UT 84015-7900
(801) 825-3582
(801) 825-8536
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
17327
UT
Other
Enumeration date
10/12/2011
Last updated
10/12/2011
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