Organization
COUNTRY PINES MEMORY CARE, LLC
Active
Other names
Country Pines Memory Care
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA E LEAVITT (EXECUTIVE DIRECTOR)
(801) 425-3271
Entity
Organization
Contact information
Practice address
1748 W 1800 N, CLINTON, UT 84015-8324
(801) 774-9198
(801) 825-3752
Mailing address
1748 W 1800 N, CLINTON, UT 84015-8324
(801) 774-9198
(801) 825-3752
Taxonomy
Speciality
Code
Description
License number
State
311500000X
Alzheimer Center (Dementia Center)
Primary
12-2014-509
UT
Other
Enumeration date
08/17/2016
Last updated
08/17/2016
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