Organization
COUNTRY PINES RETIREMENT HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH PETERSEN R.N. (DIRECTOR OF NURSING)
(801) 773-1649
Entity
Organization
Contact information
Practice address
1748 W 1800 N, CLINTON, UT 84015-8324
(801) 773-1649
Mailing address
1748 W 1800 N, CLINTON, UT 84015-8324
(801) 773-1649
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
2006-AL1-540
UT
Other
Enumeration date
12/13/2006
Last updated
08/22/2020
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