NPI 1538179981
Medallion Supported Living
Practice location
- Address
- 651 E 200 S, Lehi, UT 84043-9703
- Phone
- (801) 375-2710
- Mailing address
- PO Box 51377, Provo, UT 84605-1377
Authorised official
- Name
- Merlin C Moyes
- Title
- Administrator
- Phone
- (801) 375-2710
Registered specialties
Intellectual Disabilities Intermediate Care Facility
Primary
Registry record
- NPI
- 1538179981
- Entity type
- Organization
- NPI issued
- 8 Aug 2006
- Record last updated
- 22 Aug 2020
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.