Organization
UTAH INDEPENDENT LIVING CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBRA A, MAIR (EXECUTIVE DIRECTOR)
(801) 466-5565
Entity
Organization
Contact information
Practice address
3445 S MAIN ST, SALT LAKE CITY, UT 84115-4418
(801) 466-5565
(801) 466-2363
Mailing address
3445 S MAIN ST, SALT LAKE CITY, UT 84115-4418
(801) 466-5565
(801) 466-2363
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
0176
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0176
SERVICING AND LICENCE NUM
UT
Enumeration date
01/03/2007
Last updated
08/22/2020
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