Organization
PINE VALLEY SENIOR LIVING LLC
Active
Other names
Southgate Senior Living
Organization subpart
No
Provider details
NPI number
Authorized official
AMBER L TUELLER (SECRETARY)
(208) 369-7608
Entity
Organization
Contact information
Practice address
134 W 2025 S, ST GEORGE, UT 84770-8790
(435) 628-1117
Mailing address
134 W 2025 S, ST GEORGE, UT 84770-8790
(435) 628-1117
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
01/29/2024
Last updated
11/17/2025
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