Organization
ELK RIDGE ASSISTED LIVING
Active
Organization
ELK RIDGE ASSISTED LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRIS HERMANSEN (OWNER)
(801) 358-7343
Entity
Organization
Contact information
Practice address
218 W OLYMPIC DR, ELK RIDGE, UT 84651-5712
(801) 358-7343
Mailing address
218 W OLYMPIC DR, ELK RIDGE, UT 84651-5712
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
—
Other
Enumeration date
08/01/2013
Last updated
08/01/2013
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