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Organization

HHALMID

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CARLI PARDOE (ADMINISTRATOR)
(801) 910-9821
Entity
Organization

Contact information

Practice address
6968 S 700 E, MIDVALE, UT 84047
(801) 910-9821
Mailing address
6968 S 700 E, MIDVALE, UT 84047
(801) 910-9821

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5300233603
UT
Enumeration date
05/15/2018
Last updated
05/18/2018
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