Caresource
Organization Active NPI Skilled Nursing Facility · Salt Lake City, UT
NPI 1316490402 · NPPES record last updated Jul 26, 2016
Key facts
- NPI
- 1316490402
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 2016-NCF-UT000747 (UT)
- Legal business name
- CARESOURCE
- Practice address
- 1624 E 4500 S
Salt Lake City, UT 84117-4212 - Phone
- (801) 266-7200
- Fax
- (801) 266-7004
- NPI assigned
- Jul 26, 2016
- Organization subpart
- No
Authorized official
- Name
- Shawntel Tanner, MA, SSW
- Title
- Ceo
- Phone
- (801) 266-7200
Corporate family (same tax ID) 2
National Provider Directory
- Tax ID family
- Caresource
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 2016-NCF-UT000747 | UT | Yes |
Addresses
Primary practice location
1624 E 4500 S
Salt Lake City, UT 84117-4212
Mailing address
1624 E 4500 S
Salt Lake City, UT 84117-4212
Phone (801) 266-7200
Other names
- CareSource Rehab and Supportive Care
Other providers in Salt Lake City, UT
- Caregiver Support Network, Inc
- Caregiver Support Network, Inc
- Carepoint Health, LLC
- Carepoint Inpatient Blue Sky Neurology Utah, PLLC
- Caresource
- Caresource LLC
- Carethera
- Adrienne L Carey
- Jacob Nathaniel Carey
- John C. Carey
All providers in Salt Lake City, UT · Skilled Nursing 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 Jul 26, 2016. 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.