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General NPI Number Information
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NPI Number | 1639760291
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Entity Type | Organization
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Legal Business Name | LARLEE HOLDINGS, INC
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Dates
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Enumeration Date | 01/27/2021
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Last Update Date | 01/27/2021
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Provider Practice Location Address
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Address Line | 7069 S HIGHLAND DR
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City | COTTONWOOD HEIGHTS
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State | UT
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Zip | 84121-3724
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Country | US
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Telephone | 801-447-5353
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Fax | 801-447-6886
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Provider Business Mailing Address
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Address Line | 7069 S HIGHLAND DR
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City | COTTONWOOD HEIGHTS
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State | UT
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Zip | 84121-3724
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Country | US
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Telephone | 801-447-5353
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Fax | 801-447-6886
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Authorized Official
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Title or Position | OWNER/DON
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Name | DEVIN LARSEN
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Credential | BSN
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Telephone | 801-447-5353
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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