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PEACHTREE PLACE VII LLC NPI 1477603652


NPI Information

NPI: 1477603652
Provider Name: PEACHTREE PLACE VII LLC

Other Name: PEACHTREE PLACE OF WEST HAVEN

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization

CLIA Number: 46D2198127

Address:
4607 MIDLAND DR
WEST HAVEN, UT
ZIP 84401
Phone: (801) 732-0060
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PEACHTREE PLACE VII LLC is an assisted living facility in West Haven, 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. PEACHTREE PLACE VII LLC NPI is 1477603652. The provider is registered as an organization entity type.
The provider Other Name Is Peachtree Place Of West Haven.

The provider's business location address is:

4607 MIDLAND DR
WEST HAVEN, UT
ZIP 84401-507
Phone: (801) 732-0060
Fax: (801) 732-0120

The provider's authorized official is Jonathan Ernest Purvance .
The authorized official title is Managing Member and has the following contact phone number (801) 550-9135.

The CLIA number assigned to this NPI record is 46D2198127 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/11/2007 and was last updated on 8/22/2020.


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:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1310400000XAssisted Living Facility2005-ALLL-9990UTAHYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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