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General NPI Number Information
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NPI Number | 1831353077
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Entity Type | Organization
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Legal Business Name | REDCLIFFS SELECTCARE, INC
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Dates
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Enumeration Date | 07/16/2008
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Last Update Date | 07/16/2008
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Provider Practice Location Address
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Address Line | 375 S CARBON AVE STE A4
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City | PRICE
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State | UT
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Zip | 84501-2950
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Country | US
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Telephone | 435-630-6611
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Fax |
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Provider Business Mailing Address
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Address Line | 375 S CARBON AVE STE A4
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City | PRICE
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State | UT
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Zip | 84501-2950
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Country | US
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Telephone | 435-630-6611
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. DAVID CHET BLACKHAM
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Credential | HFA, MBA
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Telephone | 435-630-6513
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | UT
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