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Contact Information

VICTOR CLARK
6352 W 13100 S
HERRIMAN, UT84096
 Phone: 801-903-1040
 Fax: 801-446-6293
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Assisted Living Facility

310400000X
Indicates primary specialty

NPI Profile & details for

NPI # 1649687948
Entity Organization
Organization subpart 1 Not specified
Enumeration date 07/18/2014
Last updated 07/18/2014 - About 12 years ago
Identifiers
UT License # 2014-ALIIUT000651
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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