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THATCHER BROOK REHABILITATION AND CARE CENTER LLC NPI 1649454703


NPI Information

NPI: 1649454703
Provider Name: THATCHER BROOK REHABILITATION AND CARE CENTER LLC
Classification: Nursing Facility/Intermediate Care Facility - 313M00000X
Entity Type: Organization

CLIA Number: 46D2018175

Address:
1795 CHELEMES WAY
CLEARFIELD, UT
ZIP 84015
Phone: (801) 614-5700
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THATCHER BROOK REHABILITATION AND CARE CENTER LLC is a nursing facility intermediate care facility in Clearfield, UT. The provider is an institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. THATCHER BROOK REHABILITATION AND CARE CENTER LLC NPI is 1649454703. The provider is registered as an organization entity type.

The provider's business location address is:

1795 CHELEMES WAY
CLEARFIELD, UT
ZIP 84015-298
Phone: (801) 614-5700
Fax: (801) 614-5750

The provider's authorized official is Deven B Pettit .
The authorized official title is Administrator/owner and has the following contact phone number (801) 614-5700.

The CLIA number assigned to this NPI record is 46D2018175 - home health agency with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/26/2007 and was last updated on 2/10/2015.


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
1313M00000XNursing Facility/Intermediate Care FacilityYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1465169MEDICARE OSCAR/CERTIFICATIONUTAH
2465169MEDICARE PINUTAH

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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