NPI 1720098163

Medallion Manor INC.

Organisation Intellectual Disabilities Intermediate Care Facility Provo, UT

Practice location

Address: 1701 W 600 S, Provo, UT 84601-3832
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

Nursing & Custodial Care Facilities Taxonomy 315P00000X Licence 2006-NCF-69 (UT)

Other Intermediate Care Facility, Intellectual Disabilities providers in Utah →

Registry record

NPI: 1720098163
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.