Organization
COUNTRY LIFE CARE CENTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT F BUCKLEY RN (EXECUTIVE DIRECTOR)
(801) 417-9400
Entity
Organization
Contact information
Practice address
13747 S REDWOOD RD., RIVERTON, UT 84065-5712
(801) 417-9400
(801) 417-9399
Mailing address
13747 S REDWOOD RD., RIVERTON, UT 84065-5712
(801) 417-9400
(801) 417-9399
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
UT
3140N1450X
Pediatric Skilled Nursing Facility
—
UT
Other
Enumeration date
11/28/2011
Last updated
09/27/2013
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