NPI 1043518145

Medallion Supported Living-Payson

Organisation Intellectual Disabilities Intermediate Care Facility Payson, UT

Practice location

Address: 2192 W State Rd, Payson, UT 84651-4539
Phone: (801) 375-2710
Fax: (801) 377-3651
Mailing address: PO Box 51377, Provo, UT 84605-1377

Authorised official

Name: Merlin Moyes
Title: Owner
Phone: (801) 375-2710

Registered specialties

Intellectual Disabilities Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 315P00000X Licence 2011-SHCF-100069 (UT)

Other Intermediate Care Facility, Intellectual Disabilities providers in Utah →

Registry record

NPI: 1043518145
Entity type: Organization
NPI issued: 14 Mar 2011
Record last updated: 14 Mar 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.