Oak Ridge Assisted Living of Bountiful

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

OAK RIDGE ASSISTED LIVING OF BOUNTIFUL

Practice address

905 W 4000 S
Bountiful, UT 84010-8538

Phone

(801) 295-3171

NPI assigned

Mar 25, 2021

Last updated

Mar 25, 2021By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tyler Young

Title

Admin

Phone

(801) 879-2664

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1616630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616630400000",
    "number": "1316524333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 W 4000 S",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840108538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 W 4000 S",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840108538",
            "telephone_number": "801-295-3171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAK RIDGE ASSISTED LIVING OF BOUNTIFUL",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-25",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "TYLER",
        "authorized_official_title_or_position": "ADMIN",
        "authorized_official_telephone_number": "801-879-2664"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1234",
            "state": "UT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Bountiful",
            "affiliation": "N",
            "address_1": "905 W 4000 S",
            "city": "Bountiful",
            "state": "UT",
            "country_code": "US",
            "postal_code": "840108538",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Assisted Living Facility in Bountiful, UT
• Providers in Bountiful, UT by specialty
• Assisted Living Facility in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.