Organization
AVALON CARE CENTER-WILLOW WOOD, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FAYE LINCOLN (VP, POLICY/GOVERNMENT RELATIONS)
(801) 325-0153
Entity
Organization
Contact information
Practice address
1205 E 4725 S, SALT LAKE CITY, UT 84117-4917
(801) 262-2908
(801) 262-2963
Mailing address
206 N 2100 W, SALT LAKE CITY, UT 84116-4740
(801) 325-0153
(801) 596-9001
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2004-NCF-481
UT
Other
Enumeration date
08/03/2005
Last updated
08/10/2020
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