Elderly Manor Assisted Living

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

2006-ALI-239 Issued in UT

Legal business name

ELDERLY MANOR ASSISTED LIVING

Practice address

1009 Murray Holladay Rd
Salt Lake City, UT 84117-4921

Phone

(801) 268-6342

Fax

(801) 576-1372

NPI assigned

Dec 18, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Guy Mendenhall

Title

Owner

Phone

(801) 571-1010

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1700949195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 MURRAY HOLLADAY RD",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841174921",
            "telephone_number": "801-268-6342",
            "fax_number": "801-576-1372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 MURRAY HOLLADAY RD",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841174921",
            "telephone_number": "801-268-6342",
            "fax_number": "801-576-1372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELDERLY MANOR ASSISTED LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MENDENHALL",
        "authorized_official_first_name": "GUY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-571-1010",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "UT",
            "license": "2006-ALI-239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deon Elangovan
• Corinne Elde
• Elder Care, LLC
• Allison Elder
• Danny Elder
• Mercedes M Eldred
• Aidyn Keryl Eldredge
• Daniel Eldredge, C.S.W.
• David Gary Eldredge, LCSW
• Rena Eldredge, L.C.S.W.

• Assisted Living Facility in Salt Lake City, UT
• Providers in Salt Lake City, 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 Aug 22, 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.