Organization
MESA VISTA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN A ROOT (OWNER/ADMINISTRATOR)
(801) 225-9292
Entity
Organization
Contact information
Practice address
394 W 400 N, OREM, UT 84057-4663
(801) 225-9292
(801) 221-7617
Mailing address
394 W 400 N, OREM, UT 84057-4663
(801) 225-9292
(801) 221-7617
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
2006-NCF-551
UT
Other
Enumeration date
04/27/2006
Last updated
08/22/2020
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