Organization
WILLOW CREEK HOSPICE OF UTAH, LLC
Active
Other names
Pine Mountain Hospice
Organization subpart
No
Provider details
NPI number
Authorized official
TRACE D. OSBORNE CPA (ACCOUNTANT)
(801) 277-3298
Entity
Organization
Contact information
Practice address
1244 N MAIN ST, SUITE 103, TOOELE, UT 84074-9838
(435) 248-0771
(435) 248-0777
Mailing address
5200 S HIGHLAND DR, SUITE 200, HOLLADAY, UT 84117-7057
(801) 277-3298
(801) 277-3598
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
272046420001
—
UT
Enumeration date
09/03/2013
Last updated
02/21/2014
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