Organization
COUNTRY CARE LC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY S BARLOW (ADMINISTRATOR)
(801) 390-9917
Entity
Organization
Contact information
Practice address
513 S 950 W, FARMINGTON, UT 84025-4723
(801) 451-0556
Mailing address
89 COUNTRY SPRINGS CIR, KAYSVILLE, UT 84037-9819
(801) 390-9917
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
2004-ALI-959
UT
Other
Enumeration date
12/22/2006
Last updated
08/22/2020
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