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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