PETERSEN FARMS ASSISTED LIVING & MEMORY CARE (NPI# 1518525989) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1518525989 |
Entity Type | Organization |
Organization Name | PETERSEN FARMS ASSISTED LIVING & MEMORY CARE |
Practice Address |
6980 S. 475 E. South Weber UT 84405 |
Practice Telephone | 8014796000 |
Mailing Telephone | 8014796000 |
Enumeration Date | 2019-05-31 |
Last Update Date | 2019-05-31 |
Authorized Official Name | BRENT CROXFORD (ADMINISTRATOR) |
Authorized Official Telephone | 8013883848 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
Street Address |
6980 S. 475 E. |
City | SOUTH WEBER |
State | UT |
Zip Code | 84405 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1669028171 | Alyssa House | Behavioral Analyst | 4933 1500 West #110, Riverdale, UT 84405 | 2019-08-12 |
1376038141 | National Vision, Inc. | Technician/Technologist | 821 West Riverdale Road, Riverdale, UT 84405 | 2018-06-25 |
1194218461 | South Weber City | Ambulance | 7365 S 1375 E, South Weber, UT 84405 | 2018-06-12 |
1528572682 | Sandra Jo Scott | Dental Hygienist | 264 W Ridgeline Dr, Washington Terrace, UT 84405 | 2017-11-28 |
1376079061 | Loretta Shupe | Registered Nurse | 5319 S 500 E, Ogden, UT 84405 | 2017-05-02 |
1134661374 | Randy Ferrin | Registered Nurse | 5697 Maplewood Drive, South Ogden, UT 84405 | 2016-11-04 |
1871046284 | Karla Rosen | Counselor | 5202 S. Freeway Park Dr., Riverdale, UT 84405 | 2016-08-02 |
1053784520 | Jenifer Rebecca Nilson Smith | Physical Therapist | 5648 S. Adams Ave, Washington Terrace, UT 84405 | 2015-11-05 |
1972976454 | Jenniferlyn Fletcher | Physical Therapy Assistant | 5648 South Adams Ave, Washington Terrace, UT 84405 | 2015-11-05 |
1699148171 | Amanda Kathryn Trease | Occupational Therapy Assistant | 5648 South Adams Ave., Washington Terrace, UT 84405 | 2015-11-05 |
Find all providers in zip 84405 |
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 |
---|---|---|---|---|
1689273468 | Joel C. Horne & Co., Inc. | Assisted Living Facility | 831 S 700 W Bldg B, Hurricane, UT 84737-2502 | 2020-10-22 |
1578160321 | Golden Horizons, LLC | Assisted Living Facility | 535 N 600 W, Richfield, UT 84701-1767 | 2020-10-05 |
1144835117 | Sre Asl Lindon, LLC | Assisted Living Facility | 815 W 700 N, Lindon, UT 84042-1446 | 2020-09-15 |
1407461460 | Sre Asl Sg, LLC | Assisted Living Facility | 2654 Red Cliffs Dr, St George, UT 84790-5827 | 2020-09-15 |
1992319073 | Rocky Mountain Care - Vernal Manager, LLC | Assisted Living Facility | 301 E 100 S, Vernal, UT 84078-2633 | 2020-09-04 |
1558988923 | Rocky Mountain Care - Lindon Manager, LLC | Assisted Living Facility | 175 N State St, Lindon, UT 84042-1813 | 2020-07-01 |
1689294696 | Inception Holdings | Assisted Living Facility | 3306 W 3800 S, West Valley, UT 84119-4431 | 2020-04-20 |
1841828803 | Mg Cottonwood Heights Subtenant LLC | Assisted Living Facility | 7235 S Union Park Ave, Cottonwood Heights, UT 84047-4700 | 2020-03-27 |
1558993337 | Holladay Home Assisted Living LLC | Assisted Living Facility | 5950 S Highland Dr, Holladay, UT 84121-1328 | 2020-02-10 |
1740811223 | A Level Ventures | Assisted Living Facility | 940 N 2335 W, Vernal, UT 84078-8300 | 2020-02-03 |
Find all providers with the same taxonomy |
City | SOUTH WEBER |
Zip Code | 84405 |
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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.