Healthcare Provider Details

I. General information

NPI: 1780272880
Provider Name (Legal Business Name): APPLEGATE HOMECARE & HOSPICE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2021
Last Update Date: 01/05/2021
Certification Date: 12/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1492 E RIDGELINE DR STE 1
OGDEN UT
84405-4103
US

IV. Provider business mailing address

1492 E RIDGELINE DR STE 1
OGDEN UT
84405-4103
US

V. Phone/Fax

Practice location:
  • Phone: 801-621-4027
  • Fax: 801-399-9740
Mailing address:
  • Phone: 801-621-4027
  • Fax: 801-399-9740

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: TRACI LYNNE DAY
Title or Position: CFO
Credential: MBA
Phone: 801-589-8670