Healthcare Provider Details

I. General information

NPI: 1700141769
Provider Name (Legal Business Name): WEPA ENTERPRISES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2012
Last Update Date: 07/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 N 300 W
WASHINGTON UT
84780-1520
US

IV. Provider business mailing address

155 N 300 W
WASHINGTON UT
84780-1520
US

V. Phone/Fax

Practice location:
  • Phone: 435-628-8329
  • Fax:
Mailing address:
  • Phone: 435-628-8329
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number2011-ALI-9962
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number2011-SHCF-9960
License Number StateUT

VIII. Authorized Official

Name: MR. HAROLD C. WEBB
Title or Position: OWNER/ASSISTANT ADMINISTRATOR
Credential:
Phone: 435-313-8328