Organization
SUBTENANT 1430 EAST 4500 SOUTH LLC
Active
Other names
Aspen Park Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS V CROAL (SVP & CFO)
(949) 240-7200
Entity
Organization
Contact information
Practice address
1430 EAST 4500 SOUTH, SALT LAKE CITY, UT 84117-4208
(801) 272-8000
(801) 272-4983
Mailing address
6400 OAK CANYON, 200, IRVINE, CA 92618-5233
(949) 240-7200
(949) 240-7270
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
2011-HOSP-100053
UT
314000000X
Skilled Nursing Facility
—
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
911982083003
—
UT
Enumeration date
01/16/2007
Last updated
07/26/2016
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