Organization
LOVE @ HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ASHLEY DIANA DENTON LPN (OWNER/LPN)
(435) 512-6152
Entity
Organization
Contact information
Practice address
130 N MAIN ST, LEWISTON, UT 84320-1501
(435) 512-6152
Mailing address
130 N MAIN ST, LEWISTON, UT 84320-1501
(435) 512-6152
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
94107620160
UT
Other
Enumeration date
06/16/2015
Last updated
06/16/2015
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