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General NPI Number Information
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NPI Number | 1013411354
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Entity Type | Organization
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Legal Business Name | HOMESPIRE, LLC
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Dates
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Enumeration Date | 03/21/2018
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Last Update Date | 03/21/2018
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Provider Practice Location Address
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Address Line | 11520 S REDWOOD RD
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City | SOUTH JORDAN
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State | UT
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Zip | 84095-7805
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Country | US
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Telephone | 801-503-3200
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Fax |
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Provider Business Mailing Address
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Address Line | 11520 S REDWOOD RD
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City | SOUTH JORDAN
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State | UT
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Zip | 84095-7805
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VP
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Name | CAROL STANLEY
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Credential |
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Telephone | 952-223-4718
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 2018-HHA-UT000841
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License Number State | UT
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