Pine Valley Senior Living LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

PINE VALLEY SENIOR LIVING LLC

Doing business as

Southgate Senior Living

Practice address

134 W 2025 S
St George, UT 84770-8790

Phone

(435) 628-1117

NPI assigned

Jan 29, 2024

Organization subpart

No

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

Authorized official

Name

Amber L Tueller

Title

Secretary

Phone

(208) 369-7608

Specialties & licenses 1

Addresses

Other names 1

• Southgate Senior Living Doing business as

Locations

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

{
    "created_epoch": "1706486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763337600000",
    "number": "1336901834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 W 2025 S",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847708790",
            "telephone_number": "435-628-1117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 W 2025 S",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847708790",
            "telephone_number": "435-628-1117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE VALLEY SENIOR LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-29",
        "last_updated": "2025-11-17",
        "certification_date": "2025-11-17",
        "status": "A",
        "authorized_official_last_name": "TUELLER",
        "authorized_official_first_name": "AMBER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "208-369-7608"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southgate Senior Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Aaron Pitts

• Assisted Living Facility in St George, UT
• Providers in St George, 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 Nov 17, 2025; 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.