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NPI Code Detail

MEDICARE: AT HOME PERSONAL CARE

MEDICARE: AT HOME PERSONAL CARE
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
1251C00000XDevelopmentally Disabled Services Day Training Agency

General Provider Information

NPI Number : 1043295744
Entity Type Code : Organization
Provider Name (Legal Business Name) : AT HOME PERSONAL CARE
Provider Business Mailing Address
First Line : 230 W 200 S
Second Line : 2215
City : SALT LAKE CITY
State : UT
Zip : 84101-1337
Country : US
Telephone Number : 801-746-5558
Fax Number : 801-746-5559
Provider Business Practice Location Address
First Line : 230 W 200 S
Second Line : 2215
City : SALT LAKE CITY
State : UT
Zip : 84101-1337
Country : US
Telephone Number : 801-746-5558
Fax Number : 801-746-5559
Authorized Official
Title or Position : PRESIDENT/OWNER
Name : MR. RANDY SWARTWOOD
Credential : MBA, CSA
Telephone Number : 801-746-5558
Provider Enumeration Date : 12/14/2005
Last Update Date : 08/22/2020

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Directions to “AT HOME PERSONAL CARE ” Practice Location

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