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Organization

COUNTY OF DUCHESNE

Active
Other names
Uintah Basin Rehabilitation and Senior Villa
Organization subpart
No

Provider details

NPI number
Authorized official
MR. BRENT H HALES CPA (CFO)
(435) 722-6164
Entity
Organization

Contact information

Practice address
265 N 300 W, ROOSEVELT, UT 84066
(435) 725-2051
Mailing address
265 N 300 W, ROOSEVELT, UT 84066
(435) 725-2051

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
2005-NCF-50755
UT
314000000X
Skilled Nursing Facility
Primary
2014-NCF-50755
UT

Other

Enumeration date
08/31/2006
Last updated
03/10/2017
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