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WEST JORDAN CARE CENTER

Intermediate Care Facility, Mentally Retarded

West Jordan, Utah

Provider NPI: 1871570374

Organization Information:
Organization Name:  WEST JORDAN CARE CENTER


Practice Location:
3350 W 7800 S  WEST JORDAN, UT 84088 US
Tel: 801-282-0686  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y315P00000XNursing & Custodial Care Facilities
Intermediate Care Facility, Mentally Retarded
UT2004-NCF-470

Other Provider Identifiers:

IssuerNumberStateType
742561471031UT05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




MENTALLY RETARDED JOBS UT - Page 1



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