COUNTRY PINES PHASE II LC (NPI# 1104037563) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104037563 |
| Entity Type | Organization |
| Organization Name | COUNTRY PINES PHASE II LC |
| Practice Address |
1706 W 1800 N Clinton UT 84015-8324 |
| Practice Telephone | 8017730990 |
| Mailing Telephone | 8017730990 |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MYRNA L MCCLELLAN (ADMINISTRATOR) |
| Authorized Official Telephone | 8017730990 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | 006871 | UT | Nursing & Custodial Care Facilities |
| Street Address |
1706 W 1800 N |
| City | CLINTON |
| State | UT |
| Zip Code | 84015-8324 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235751900 | Roe Rx Inc | Pharmacy | 145 S 3000 W, West Point, UT 84015 | 2020-05-15 |
| 1619459104 | Jaime W Jones | Registered Nurse | 412 North 4950 West, West Point, UT 84015 | 2018-08-31 |
| 1295272557 | Wendy Fleming | Registered Nurse | 22 So. State Street, Davis County Health Dept, Clearfield, UT 84015 | 2017-01-25 |
| 1871041707 | Megan Claire Mannen | Optometrist | 1448 N 2000 W Ste 3, Clinton, UT 84015 | 2016-09-20 |
| 1093118291 | April Riney | Counselor | 189 S State St Ste 235b, Clearfield, UT 84015 | 2014-10-01 |
| 1457779381 | Katherine Olsen | Registered Nurse | 22 S. State St., Clearfield, UT 84015 | 2014-03-28 |
| 1336560218 | Lauren April Call | Registered Nurse | 22 S. State St, Clearfield, UT 84015 | 2013-12-19 |
| 1568803377 | John Gaspare Rino | Physical Therapist | 29 C St, Clearfield, UT 84015 | 2013-07-09 |
| 1912243247 | Clinton Dental Group, LLP | Dentist | 1737 North 2000 West, Suite G, Clinton, UT 84015 | 2012-12-13 |
| 1639441264 | Kim I Beus | Nurse Practitioner | 383 E 1900 S, Clearfield, UT 84015 | 2012-01-27 |
| Find all providers in zip 84015 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497360986 | Merle Newkirk | Assisted Living Facility | 7606 Fox Hunt Ct, Clinton, MD 20735-3063 | 2020-09-10 |
| 1659982452 | Clinton Alf Operations LLC | Assisted Living Facility | 91 E Main St, Clinton, CT 06413-2139 | 2020-08-14 |
| 1306465745 | Cedar Senior Living, LLC. | Assisted Living Facility | 670 Cedar Lake Ln, Clinton, NC 28328-8986 | 2020-04-15 |
| 1336779248 | Meadow View Senior Living | Assisted Living Facility | 111 Acuff Ln, Clinton, TN 37716-6892 | 2020-01-20 |
| 1619491149 | Carolina Christian Ministrties | Assisted Living Facility | 300 Jacobs Hwy, Clinton, SC 29325-9400 | 2017-07-26 |
| 1649722158 | Chiama Group, Inc. | Assisted Living Facility | 6709 Briarcliff Dr, Clinton, MD 20735-4002 | 2016-11-01 |
| 1093188344 | Indiana's Center for Foot and Ankle Care, P.C. | Assisted Living Facility | 135 Green Forest Dr, Clinton, MS 39056-2235 | 2015-11-09 |
| 1457790420 | Peaceful Life Assisted Living | Assisted Living Facility | 7029 Groveton Dr, Clinton, MD 20735-4046 | 2013-06-22 |
| 1285821587 | Assisted Living Concepts Inc | Assisted Living Facility | 939 Springdale Drive, Clinton, SC 29325 | 2007-10-01 |
| 1790991354 | Bristol Care, Inc. | Assisted Living Facility | 1402 E Franklin St, Clinton, MO 64735-1768 | 2007-05-14 |
| Find all providers in CLINTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.