Organization
UTNV EAST MILLCREEK, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH ASSIRAN (MANAGER)
(410) 769-5882
Entity
Organization
Contact information
Practice address
1871 E 3300 S, SALT LAKE CITY, UT 84106-3969
(801) 485-0123
Mailing address
1422 CLARKVIEW RD, BALTIMORE, MD 21209-2385
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
2011-ALII-976
UT
Other
Enumeration date
12/11/2013
Last updated
12/11/2013
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