EXTENDED CARE PORTFOLIO MULTISTATE POOL TENANT LLC NPI 1801295894

NPI Information

EXTENDED CARE PORTFOLIO MULTISTATE POOL TENANT, LLC is an assisted living facility in Salt Lake City, UT. The provider is 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. EXTENDED CARE PORTFOLIO MULTISTATE POOL TENANT, LLC NPI is 1801295894. The provider is registered as an organization entity type.
The provider Is Doing Business As Pacifica Senior Living Millcreek.

The provider's business location address is:

777 E 3900 S
SALT LAKE CITY, UT
ZIP 84107-199
Phone: (801) 288-0700
Fax: (801) 288-2777

The provider's authorized official is Deepak Israni .
The authorized official title is Manager and has the following contact phone number (619) 296-9000.

The CLIA number assigned to this NPI record is 46D2050927 - other - assisted living with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/15/2014 and was last updated on 8/15/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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