Provider Demographics
NPI:1932265717
Name:RETIREMENT LIVING GROUP
Entity type:Organization
Organization Name:RETIREMENT LIVING GROUP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:TINKHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-966-4286
Mailing Address - Street 1:2011 W 4700 S
Mailing Address - Street 2:
Mailing Address - City:TAYLORSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84118-1107
Mailing Address - Country:US
Mailing Address - Phone:801-966-4286
Mailing Address - Fax:
Practice Address - Street 1:2011 W 4700 S
Practice Address - Street 2:
Practice Address - City:TAYLORSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84118-1107
Practice Address - Country:US
Practice Address - Phone:801-966-4286
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2005ALI600310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility