Organization
CARESOURCE CHARITABLE ASSOCIATION
Active
Organization
CARESOURCE CHARITABLE ASSOCIATION
Active
Other names
CareSource Hospice at Home
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWNTEL YATES TANNER MA, CHPCA, SSW, PHR (ADMINISTRATOR)
(801) 266-7200
Entity
Organization
Contact information
Practice address
750 KEARNS BLVD # 200, PARK CITY, UT 84060-5137
(801) 266-7200
(801) 266-7004
Mailing address
750 KEARNS BLVD. #200, PO BOX 683593, PARK CITY, UT 84068-3593
(801) 266-7200
(801) 266-7004
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
2016
UT
Other
Enumeration date
09/07/2016
Last updated
11/14/2016
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