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General NPI Number Information
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NPI Number | 1811456205
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Entity Type | Organization
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Legal Business Name | DECEMBER ROSE SENIOR CARE AT HOME
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Dates
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Enumeration Date | 03/15/2019
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Last Update Date | 03/15/2019
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Provider Practice Location Address
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Address Line | 12051 N ITHICA DR
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City | HIGHLAND
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State | UT
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Zip | 84003-3684
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Country | US
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Telephone | 801-427-7673
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Fax |
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Provider Business Mailing Address
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Address Line | 12051 N ITHICA DR
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City | HIGHLAND
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State | UT
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Zip | 84003-3684
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Country | US
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Telephone | 801-427-7673
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ALAN D JONES
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Credential |
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Telephone | 801-850-4320
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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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