Country Pines Phase II LC
Organization Active NPI Assisted Living Facility · Clinton, UT
NPI 1104037563 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1104037563
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Assisted Living Facility 310400000X
- License
- 006871 (UT)
- Legal business name
- COUNTRY PINES PHASE II LC
- Practice address
- 1706 W 1800 N
Clinton, UT 84015-8324 - Phone
- (801) 773-0990
- NPI assigned
- May 25, 2007
- Organization subpart
- No
Authorized official
- Name
- Myrna L McClellan
- Title
- Administrator
- Phone
- (801) 773-0990
National Provider Directory
Locations
1706 W 1800 N
Clinton, UT 84015
Phone (801) 773-0990
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | 006871 | UT | Yes |
Addresses
Primary practice location
1706 W 1800 N
Clinton, UT 84015-8324
Mailing address
1706 W 1800 N
Clinton, UT 84015-8324
Phone (801) 773-0990
Other providers in Clinton, UT
- Erin Elizabethcotter Cotter
- Country Niche Adult Day Care
- Country Niche Adult Day Care LLC
- Country Niche Adult Day Center
- Country Pines Memory Care, LLC
- Country Pines Retirement Home
- Kaden Craig
- Marcus Cressall
- Alyssa Crowe
- Markie Cummins
All providers in Clinton, UT · Assisted Living Facility in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.