Avalon Care Center-Willow Wood, Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

2004-NCF-481 Issued in UT

Legal business name

AVALON CARE CENTER-WILLOW WOOD, INC

Practice address

1205 E 4725 S
Salt Lake City, UT 84117-4917

Phone

(801) 262-2908

Fax

(801) 262-2963

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

Locations

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

{
    "created_epoch": "1123027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597017600000",
    "number": "1689675340",
    "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": "841164740",
            "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": "1205 E 4725 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841174917",
            "telephone_number": "801-262-2908",
            "fax_number": "801-262-2963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVALON CARE CENTER-WILLOW WOOD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-03",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "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-481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zachary Autry, MA, CMHC
• Mia Auzina
• Normund Karl Auzins, D.D.S.
• Avalon Ancillary Services,L.L.C.
• Avalon Care Center - Canyon Rim, LLC (Canyon Rim Care Center)
• Avalon VA HH LLC (Veterans Homecare Services)
• Avalon Valley Care Center LLC
• Andrew Avati
• Andrea Avelino Jimenez
• James Monroe Avent, MD

• 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 Aug 10, 2020; 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.