Country Life Care Centers

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

COUNTRY LIFE CARE CENTERS

Practice address

13747 S Redwood Rd.
Riverton, UT 84065-5712

Phone

(801) 417-9400

Fax

(801) 417-9399

NPI assigned

Nov 28, 2011

Organization subpart

No

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

Authorized official

Name

Robert F Buckley, RN

Title

Executive Director

Phone

(801) 417-9400

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1322438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380240000000",
    "number": "1639446297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13747 S REDWOOD RD.",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840655712",
            "telephone_number": "801-417-9400",
            "fax_number": "801-417-9399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13747 S REDWOOD RD.",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840655712",
            "telephone_number": "801-417-9400",
            "fax_number": "801-417-9399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTRY LIFE CARE CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-28",
        "last_updated": "2013-09-27",
        "status": "A",
        "authorized_official_last_name": "BUCKLEY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "801-417-9400",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "UT",
            "license": null,
            "primary": true
        },
        {
            "code": "3140N1450X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility, Nursing Care, Pediatric",
            "state": "UT",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2013; 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.