Organization
KEYSTONE RESIDENTIAL CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOANA OLIVIA HANSEN (EXECUTIVE DIRECTOR)
(801) 949-8509
Entity
Organization
Contact information
Practice address
6062 S HIDDEN PL, TAYLORSVILLE, UT 84123-7676
(801) 949-8509
Mailing address
6062 S HIDDEN PL, TAYLORSVILLE, UT 84123-7676
(801) 949-8509
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
—
—
Other
Enumeration date
12/02/2020
Last updated
12/02/2020
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