Healthcare Provider Details

I. General information

NPI: 1902798739
Provider Name (Legal Business Name): QUAIL MEADOWS ASSISTED LIVING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2025
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

786 E 2100 N
NORTH OGDEN UT
84414-2935
US

IV. Provider business mailing address

786 E 2100 N
NORTH OGDEN UT
84414-2935
US

V. Phone/Fax

Practice location:
  • Phone: 801-782-7440
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License Number
License Number State

VIII. Authorized Official

Name: TANNER THOMAS
Title or Position: CFO
Credential:
Phone: 435-890-6200