Healthcare Provider Details

I. General information

NPI: 1437660297
Provider Name (Legal Business Name): NEW HORIZONS HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2017
Last Update Date: 10/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1030 W BELLWOOD LN
SALT LAKE CITY UT
84123-4494
US

IV. Provider business mailing address

15102 S BRIAR CREST CT
DRAPER UT
84020-5538
US

V. Phone/Fax

Practice location:
  • Phone: 801-856-2826
  • Fax:
Mailing address:
  • Phone: 801-856-2826
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: FRANK L FULLMER
Title or Position: MANAGER
Credential:
Phone: 801-856-2826