National Provider Identifier Database

PETERSEN FARMS ASSISTED LIVING MEMORY CARE
Assisted Living Facility

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.


Contact Information

PETERSEN FARMS ASSISTED LIVING & MEMORY CARE
6980 S. 475 E.
SOUTH WEBER, UT84405
Phone: 801-479-6000
Fax:
Website:
Specialty Taxonomy Code
* Assisted Living Facility 310400000X

* Indicates primary specialty

NPI Profile & details for PETERSEN FARMS ASSISTED LIVING & MEMORY CARE

NPI Number 1518525989
Legal business name
LBN
PETERSEN FARMS ASSISTED LIVING & MEMORY CARE
Authorized official BRENT CROXFORD - (ADMINISTRATOR)
Entity Organization
Organization subpart No
Enumeration date 05/31/2019
Last updated 05/31/2019 - About 7 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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