PROVO CARE CENTER
Intermediate Care Facility, Mentally Retarded
Provo, Utah
Provider NPI: 1598764862
Organization Information:Organization Name: PROVO CARE CENTER
Practice Location:
256 E CENTER ST PROVO, UT 84606 US
Tel: 180-137-3877 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Practice Location:
256 E CENTER ST PROVO, UT 84606 US
Tel: 180-137-3877 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 315P00000X | Nursing & Custodial Care Facilities Intermediate Care Facility, Mentally Retarded | UT | 2004-NCF-79 |