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NPI Code Detail

MEDICARE: SALISBURY ASSISTED LIVING, LLC

MEDICARE: SALISBURY ASSISTED LIVING, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1310400000XAssisted Living Facility

General Provider Information

NPI Number : 1629616867
Entity Type Code : Organization
Provider Name (Legal Business Name) : SALISBURY ASSISTED LIVING, LLC
Provider Business Mailing Address
First Line : 522 E 100 S
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84102-1905
Country : US
Telephone Number : 801-485-5055
Fax Number : 801-467-3296
Provider Business Practice Location Address
First Line : 574 E 100 S
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84102-1905
Country : US
Telephone Number : 801-485-5055
Fax Number : 801-467-3296
Authorized Official
Title or Position : MANAGER
Name : MR. MARK CACCIAMANI
Credential : MD
Telephone Number : 801-485-5055
Provider Enumeration Date : 12/18/2019
Last Update Date : 12/18/2019

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Directions to “SALISBURY ASSISTED LIVING, LLC ” Practice Location

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