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General NPI Number Information
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NPI Number | 1477903375
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Entity Type | Organization
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Legal Business Name | UTAH COMMUNITY HEALTHCARE INC.
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Dates
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Enumeration Date | 06/21/2016
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Last Update Date | 06/20/2023
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Provider Practice Location Address
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Address Line | 1561 W 7000 S
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City | WEST JORDAN
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State | UT
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Zip | 84084-3556
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Country | US
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Telephone | 801-921-0270
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Fax | 801-747-6881
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Provider Business Mailing Address
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Address Line | 1561 W 7000 S STE 100
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City | WEST JORDAN
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State | UT
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Zip | 84084-3556
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Country | US
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Telephone | 801-921-0270
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Fax | 801-747-6881
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. JORGE GUSTAVO GONZALEZ
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Credential |
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Telephone | 801-921-0270
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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 | 2016-HHA-UT000763
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License Number State | UT
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