Healthcare Provider Details

I. General information

NPI: 1649770777
Provider Name (Legal Business Name): SUZY'S SENIOR COMPANIONSHIP SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2018
Last Update Date: 04/26/2024
Certification Date: 04/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1052 E 3250 N
LAYTON UT
84040-6577
US

IV. Provider business mailing address

1052 E 3250 N
LAYTON UT
84040-6577
US

V. Phone/Fax

Practice location:
  • Phone: 801-540-2077
  • Fax:
Mailing address:
  • Phone: 801-540-2077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateNULL
# 5
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL
# 6
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number StateNULL

VIII. Authorized Official

Name: SUZY RIDLEY LARSEN
Title or Position: CEO /PRESIDENT
Credential:
Phone: 801-540-0487