Organization
PROVIDENTIAL BBA OPERATING LP
Active
Other names
Specialty Hospital of Utah, Specialty Hospital of Utah, Western Peaks Specialty Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID A. BLAND (CEO)
(801) 397-8101
Entity
Organization
Contact information
Practice address
485 E 500 S, BOUNTIFUL, UT 84010-3801
(801) 295-2361
(801) 295-1398
Mailing address
401 SOUTH 400 EAST, BOUNTIFUL, UT 84010
(801) 295-2361
(801) 295-1398
Taxonomy
Speciality
Code
Description
License number
State
281P00000X
Chronic Disease Hospital
2005HOSP207
UT
282E00000X
Long Term Care Hospital
Primary
2016HOSP207
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1982647103
—
UT
Enumeration date
06/14/2006
Last updated
06/22/2020
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