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General NPI Number Information
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NPI Number | 1063697365
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Entity Type | Organization
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Legal Business Name | UTAH HOMECARE LLC
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Dates
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Enumeration Date | 01/04/2008
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Last Update Date | 01/13/2023
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Provider Practice Location Address
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Address Line | 9231 S REDWOOD RD BLDG 4
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City | WEST JORDAN
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State | UT
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Zip | 84088-6570
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Country | US
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Telephone | 801-566-1185
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Fax | 801-469-6394
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Provider Business Mailing Address
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Address Line | 9231 S REDWOOD RD BLDG 4
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City | WEST JORDAN
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State | UT
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Zip | 84088-6570
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Country | US
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Telephone | 801-774-9698
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Fax | 801-469-6394
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | NANNETTE RODRIGUEZ
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Credential |
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Telephone | 801-774-9698
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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 | 2007-HHA-75934
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License Number State | UT
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