Organization
AVALON CARE CENTER - CANYON RIM, LLC
Active
Other names
Canyon Rim Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
FAYE LINCOLN (VP, POLICY/GOVERNMENT RELATIONS)
(801) 325-0153
Entity
Organization
Contact information
Practice address
2730 E 3300 S, SALT LAKE CITY, UT 84109-2819
(801) 487-0896
(801) 487-0912
Mailing address
206 N 2100 W, SALT LAKE CITY, UT 84116-2927
(801) 325-0153
(801) 596-9001
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2004-NCF-105
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
870426816000
—
UT
Enumeration date
08/03/2005
Last updated
05/02/2016
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