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General NPI Number Information
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NPI Number | 1083718522
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Entity Type | Organization
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Legal Business Name | AT HOME PERSONAL CARE
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Dates
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Enumeration Date | 09/12/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 230 W 200 S STE 2613
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City | SALT LAKE CITY
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State | UT
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Zip | 84101-3487
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Country | US
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Telephone | 801-746-5558
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Fax |
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Provider Business Mailing Address
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Address Line | 230 W 200 S STE 2613
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City | SALT LAKE CITY
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State | UT
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Zip | 84101-3487
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Country | US
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Telephone | 801-746-5558
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MISS CHRISTY BUSKIRK
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Credential |
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Telephone | 801-746-5558
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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 |
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License Number State | UT
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