Organization
RENAISSANCE REHABILITATION OF SOUTH JORDAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAD CROOKSTON (EXECUTIVE DIRECTOR)
(801) 920-9566
Entity
Organization
Contact information
Practice address
1371 WEST SOUTH JORDAN PARKWAY, SOUTH JORDAN, UT 84095
(801) 920-9566
Mailing address
1043 RAYMOND RD, FRUIT HEIGHTS, UT 84037-2249
(801) 444-3233
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
05/18/2007
Last updated
07/26/2007
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