MEDICARE: APPLE VILLAGE AL 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

General Provider Information

NPI Number	:	1619865144
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	APPLE VILLAGE AL LLC

Provider Business Mailing Address
First Line	:	13105 S BOULTER ST
Second Line	:
City	:	DRAPER
State	:	UT
Zip	:	84020-9165
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2600 E HOBBS VIEW CIR
Second Line	:
City	:	LAYTON
State	:	UT
Zip	:	84040-7112
Country	:	US
Telephone Number	:	801-771-2525
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	CALEB WEILER
Credential	:
Telephone Number	:	801-669-4090

Provider Enumeration Date	:	06/24/2025
Last Update Date	:	06/24/2025

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Directions to “APPLE VILLAGE AL LLC ” Practice Location

Language	Start Address	Practice Location

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