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General NPI Number Information
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NPI Number | 1891857272
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Entity Type | Organization
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Legal Business Name | APPLE TREE ASSISTED LIVING
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Dates
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Enumeration Date | 12/14/2006
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Last Update Date | 08/17/2007
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Provider Practice Location Address
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Address Line | 565 N 300 W
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City | KAYSVILLE
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State | UT
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Zip | 84037-3102
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Country | US
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Telephone | 801-546-5600
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Fax | 801-546-5606
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Provider Business Mailing Address
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Address Line | 565 N 300 W
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City | KAYSVILLE
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State | UT
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Zip | 84037-3102
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Country | US
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Telephone | 801-546-5600
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Fax | 801-546-5606
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JENIFER H. JOHNSON
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Credential |
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Telephone | 801-546-5600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 2006-ALI-485
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License Number State | UT
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