Healthcare Provider Details

I. General information

NPI: 1255612487
Provider Name (Legal Business Name): KANE COUNTY HUMAN RESOURCE SPECIAL SERVICE DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2011
Last Update Date: 04/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

538 S 500 E
AMERICAN FORK UT
84003
US

IV. Provider business mailing address

538 S 500 E
AMERICAN FORK UT
84003
US

V. Phone/Fax

Practice location:
  • Phone: 801-642-2000
  • Fax: 801-642-2200
Mailing address:
  • Phone: 801-642-2000
  • Fax: 801-642-2200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. CORY ROBISON
Title or Position: MANAGER
Credential:
Phone: 801-960-9000