Organization
CHP LAYTON UT TENANT CORP
Active
Other names
Fairfield Village Rehabilition
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN RAY MADDRON (SENIOR VICE PRESIDENT)
(407) 540-7519
Entity
Organization
Contact information
Practice address
1203 N FAIRFIELD RD, LAYTON, UT 84041-8321
(801) 807-0111
Mailing address
450 S ORANGE AVE, ORLANDO, FL 32801-3383
(407) 540-7652
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2015-NCF-UT000437
UT
Other
Enumeration date
10/10/2014
Last updated
08/12/2015
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