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Organization

COUNTRY LANE PAYSON OPERATING LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JARED ANDERSEN (OWNER)
(801) 928-3997
Entity
Organization

Contact information

Practice address
153 S. 900 E, PAYSON, UT 84651
(801) 465-1490
(801) 465-3579
Mailing address
1133 N. MAIN ST, SUITE 210, LAYTON, UT 84041
(801) 546-7417
(801) 546-5230

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
2016AL11UT207238
UT

Other

Enumeration date
06/30/2016
Last updated
06/30/2016
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