Provider Demographics
NPI:1588895676
Name:WASATCH HOME HEALTH CARE SERVICES
Entity type:Organization
Organization Name:WASATCH HOME HEALTH CARE SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:FLORENCE
Authorized Official - Middle Name:N
Authorized Official - Last Name:GEO-JAJA
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:801-953-1713
Mailing Address - Street 1:9103 S 1300 W
Mailing Address - Street 2:SUITE # 102
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84088-6706
Mailing Address - Country:US
Mailing Address - Phone:801-953-1713
Mailing Address - Fax:801-953-1519
Practice Address - Street 1:9103 S 1300 W
Practice Address - Street 2:SUITE # 102
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84088-6706
Practice Address - Country:US
Practice Address - Phone:801-953-1713
Practice Address - Fax:801-953-1519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-06
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2009-HHA-89048251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health