Provider Demographics
NPI:1649820341
Name:ANDERSON CARE HOME
Entity type:Organization
Organization Name:ANDERSON CARE HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:HANNAH
Authorized Official - Middle Name:FAYE
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:435-720-7295
Mailing Address - Street 1:1295 N 1700 W
Mailing Address - Street 2:
Mailing Address - City:FARR WEST
Mailing Address - State:UT
Mailing Address - Zip Code:84404-3498
Mailing Address - Country:US
Mailing Address - Phone:435-720-7295
Mailing Address - Fax:
Practice Address - Street 1:1295 N 1700 W
Practice Address - Street 2:
Practice Address - City:FARR WEST
Practice Address - State:UT
Practice Address - Zip Code:84404-3498
Practice Address - Country:US
Practice Address - Phone:435-720-7295
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-13
Last Update Date:2019-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251J00000XAgenciesNursing Care
No273Y00000XHospital UnitsRehabilitation Unit
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No385H00000XRespite Care FacilityRespite Care