South Valley Healthcare, Inc.
Organization Active NPI Skilled Nursing Facility · Salt Lake City, UT
NPI 1710040795 · NPPES record last updated Jun 3, 2016
Key facts
- NPI
- 1710040795
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 2007-NCF-78400 (UT)
- Legal business name
- SOUTH VALLEY HEALTHCARE, INC.
- Practice address
- 4782 Holladay Blvd
Salt Lake City, UT 84117-5444 - Phone
- (949) 487-9500
- Fax
- (949) 540-3007
- NPI assigned
- Dec 19, 2006
- Organization subpart
- No
Authorized official
- Name
- Ms. Soon Burnam
- Title
- Treasurer of Management Company
- Phone
- (949) 540-1249
Corporate family (same tax ID) 24
Practitioners 1
-
Antoinette T Hubenette, M.D.
National Provider Directory
- Tax ID family
- B N Robinson MD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 2007-NCF-78400 | UT | Yes |
Addresses
Primary practice location
4782 Holladay Blvd
Salt Lake City, UT 84117-5444
Mailing address
27101 Puerta Real
Suite 450
Mission Viejo, CA 92691-8518
Phone (949) 487-9500
Other names
- Holladay Healthcare Center
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 3, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.