MEDICARE: ZIONS MOUNTAIN VIEW HOME & ASSOC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility

General Provider Information

NPI Number	:	1033441597
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ZIONS MOUNTAIN VIEW HOME & ASSOC.

Provider Business Mailing Address
First Line	:	255 E 400 S
Second Line	:	SUITE 200
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84111-2846
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2730 E 3300 S
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84109-2819
Country	:	US
Telephone Number	:	801-487-0896
Fax Number	:	801-487-0912

Authorized Official
Title or Position	:	VICE PRESIDENT POLICY & GOVT RELATI
Name	:	FAYE LINCOLN
Credential	:
Telephone Number	:	801-325-0153

Provider Enumeration Date	:	02/09/2010
Last Update Date	:	08/09/2010

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