Avalon Care Center - Canyon Rim, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

2004-NCF-105 Issued in UT

Legal business name

AVALON CARE CENTER - CANYON RIM, LLC

Practice address

2730 E 3300 S
Salt Lake City, UT 84109-2819

Phone

(801) 487-0896

Fax

(801) 487-0912

NPI assigned

Aug 3, 2005

Organization subpart

No

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

Authorized official

Name

Faye Lincoln

Title

VP, Policy/Government Relations

Phone

(801) 325-0153

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Canyon Rim Care Center Doing business as

Tax ID family

Avalon Care Center - Canyon Rim LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Zions Mountain View Home & Assoc.

  • Skilled Nursing Facility
  • Salt Lake City, UT
  • NPI 1033441597
  NPD tax ID

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

{
    "created_epoch": "1123027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462147200000",
    "number": "1639170384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 N 2100 W",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841162927",
            "telephone_number": "801-325-0153",
            "fax_number": "801-596-9001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2730 E 3300 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841092819",
            "telephone_number": "801-487-0896",
            "fax_number": "801-487-0912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVALON CARE CENTER - CANYON RIM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-03",
        "last_updated": "2016-05-02",
        "status": "A",
        "authorized_official_last_name": "LINCOLN",
        "authorized_official_first_name": "FAYE",
        "authorized_official_title_or_position": "VP, POLICY/GOVERNMENT RELATIONS",
        "authorized_official_telephone_number": "801-325-0153"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "UT",
            "license": "2004-NCF-105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "870426816000",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Canyon Rim Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Emily Auton
• Zachary Autry, MA, CMHC
• Mia Auzina
• Normund Karl Auzins, D.D.S.
• Avalon Ancillary Services,L.L.C.
• Avalon Care Center-Willow Wood, Inc
• Avalon VA HH LLC
• Avalon Valley Care Center LLC
• Andrew Avati
• Andrea Avelino Jimenez

• Skilled Nursing Facility in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Skilled Nursing Facility in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2016; 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.