Organization
PROVIDENCE CITY, LLC
Active
Other names
CACHE VALLEY SENIOR LIVING COMMUNITY
Organization subpart
No
Provider details
NPI number
Authorized official
JON HARDER (MANAGER)
(503) 485-4600
Entity
Organization
Contact information
Practice address
233 N MAIN ST, PROVIDENCE, UT 84332-9622
(435) 792-4770
Mailing address
3723 FAIRVIEW INDUSTRIAL DR SE STE 270, SALEM, OR 97302-4975
(503) 485-4600
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
UT
Other
Enumeration date
04/17/2007
Last updated
08/22/2020
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