Provider Demographics
NPI:1215935432
Name:UINTAH HEALTH CARE SPECIAL SERVICE DISTRICT
Entity type:Organization
Organization Name:UINTAH HEALTH CARE SPECIAL SERVICE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNBAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-781-3511
Mailing Address - Street 1:510 S 500 W
Mailing Address - Street 2:
Mailing Address - City:VERNAL
Mailing Address - State:UT
Mailing Address - Zip Code:84078-4301
Mailing Address - Country:US
Mailing Address - Phone:435-781-3505
Mailing Address - Fax:435-789-3201
Practice Address - Street 1:510 S 500 W
Practice Address - Street 2:
Practice Address - City:VERNAL
Practice Address - State:UT
Practice Address - Zip Code:84078-4301
Practice Address - Country:US
Practice Address - Phone:435-781-3500
Practice Address - Fax:435-789-3201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-12
Last Update Date:2017-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2005-NCF-94314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT519160002004Medicaid
UT519160002004Medicaid