MEDICARE: WELLINGTON MSL, LLC

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	310400000X	Assisted Living Facility	2011-ALII-50458	UT

General Provider Information

NPI Number	:	1568759488
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WELLINGTON MSL, LLC

Provider Business Mailing Address
First Line	:	175 TECHNOLOGY DR
Second Line	:	STE 200
City	:	IRVINE
State	:	CA
Zip	:	92618-2478
Country	:	US
Telephone Number	:	949-242-1400
Fax Number	:

Provider Business Practice Location Address
First Line	:	4522 S 1300 E
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84117-4177
Country	:	US
Telephone Number	:	801-281-3477
Fax Number	:	801-268-1854

Authorized Official
Title or Position	:	SENIOR VICE PRESIDENT AND CFO
Name	:	MR. LARY SIMON
Credential	:
Telephone Number	:	949-242-1400

Provider Enumeration Date	:	06/29/2011
Last Update Date	:	06/29/2011

Similar Medicare Providers

1588163869 — SSSHT OPCO 4522 S 1300 E LLC
Practice Location Address:

4522 S 1300 E
SALT LAKE CITY, UT
84117-4177

Practice Phone: 801-281-3477
Practice Fax:

1861138893 — LISA MARIE SCHIFF
Practice Location Address:

4522 S 1300 E
SALT LAKE CITY, UT
84117-4177

Practice Phone: 385-743-2171
Practice Fax:

1891976452 — MRS. ELIZABETH TREAT MORRIS P.T.
Practice Location Address:

4177 MATHEWS WAY
SALT LAKE CITY, UT
84124-4021

Practice Phone: 801-272-3118
Practice Fax: 801-277-9724

1447826045 — JEREMY KLEBBA MOTR/L
Practice Location Address:

50 N MEDICAL DR
SALT LAKE CITY, UT
84132-4177

Practice Phone: 801-581-2121
Practice Fax:

1083789770 — OK SENIOR HOUSING HOLLADAY
Practice Location Address:

4522 S 1300 E
SLC, UT
84117-4177

Practice Phone: 801-281-3477
Practice Fax: 801-268-1854

1568207884 — MICHAEL JONATHAN HALL DPT
Practice Location Address:

4522 S 1300 E
MILLCREEK, UT
84117-4177

Practice Phone: 385-446-9881
Practice Fax:

Directions to “WELLINGTON MSL, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.