Provider Demographics
NPI:1275356131
Name:KCP UTAH INCORPORATED
Entity type:Organization
Organization Name:KCP UTAH INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FRANCHISE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:PLYMALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:385-535-3066
Mailing Address - Street 1:369 W 2875 N
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-3394
Mailing Address - Country:US
Mailing Address - Phone:385-535-3066
Mailing Address - Fax:
Practice Address - Street 1:369 W 2875 N
Practice Address - Street 2:
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-3394
Practice Address - Country:US
Practice Address - Phone:385-535-3066
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-07
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care