Healthcare Provider Details

I. General information

NPI: 1487531885
Provider Name (Legal Business Name): SENIOR HEALTH HOME SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2025
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

598 W 900 S STE 230
WOODS CROSS UT
84010-8195
US

IV. Provider business mailing address

576 W 900 S STE 220
WOODS CROSS UT
84010-8194
US

V. Phone/Fax

Practice location:
  • Phone: 801-397-4040
  • Fax:
Mailing address:
  • Phone: 801-397-4697
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JASON GATHERUM
Title or Position: PRESIDENT AND CD)
Credential:
Phone: 801-397-4187