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General NPI Number Information
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NPI Number | 1659505501
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Entity Type | Organization
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Legal Business Name | HOSPICE CARE OF NORTHERN UTAH, LLC
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Dates
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Enumeration Date | 05/06/2009
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Last Update Date | 08/19/2013
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Provider Practice Location Address
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Address Line | 2721 N HWY 89 SUITE 200
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City | PLEASANT VIEW
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State | UT
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Zip | 84404-6258
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Country | US
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Telephone | 801-689-3049
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Fax | 801-689-3045
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Provider Business Mailing Address
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Address Line | 2721 N HWY 89 SUITE 200
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City | PLEASANT VIEW
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State | UT
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Zip | 84404-6258
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Country | US
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Telephone | 801-689-3049
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Fax | 801-689-3045
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | MS. EILEEN D WOOD
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Credential | MSN, CHPN
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Telephone | 801-689-3049
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 1015860
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License Number State | UT
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