Healthcare Provider Details

I. General information

NPI: 1326407578
Provider Name (Legal Business Name): S-H CLEARFIELD OPCO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2016
Last Update Date: 02/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1425 S 1500 E
CLEARFIELD UT
84015-1613
US

IV. Provider business mailing address

4 PARK PLZ SUITE 400
IRVINE CA
92614-8560
US

V. Phone/Fax

Practice location:
  • Phone: 801-779-0798
  • Fax:
Mailing address:
  • Phone: 949-242-1432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: KENT CRANDALL
Title or Position: CFO
Credential:
Phone: 949-789-8486