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General NPI Number Information
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NPI Number | 1487531885
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Entity Type | Organization
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Legal Business Name | SENIOR HEALTH HOME SERVICES LLC
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Dates
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Enumeration Date | 08/18/2025
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 598 W 900 S STE 230
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City | WOODS CROSS
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State | UT
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Zip | 84010-8195
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Country | US
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Telephone | 801-397-4040
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Fax |
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Provider Business Mailing Address
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Address Line | 576 W 900 S STE 220
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City | WOODS CROSS
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State | UT
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Zip | 84010-8194
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Country | US
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Telephone | 801-397-4697
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Fax |
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Authorized Official
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Title or Position | PRESIDENT AND CD)
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Name | JASON GATHERUM
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Credential |
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Telephone | 801-397-4187
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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