Provider Demographics
NPI:1033357462
Name:AHC OF OREM LLC
Entity Type:Organization
Organization Name:AHC OF OREM LLC
Other - Org Name:ASPEN RIDGE OF UTAH VALLEY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:OXNAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-480-9860
Mailing Address - Street 1:1992 S COLUMBIA LANE
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84097-9124
Mailing Address - Country:US
Mailing Address - Phone:801-724-6500
Mailing Address - Fax:
Practice Address - Street 1:1992 S COLUMBIA LANE
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84097-9124
Practice Address - Country:US
Practice Address - Phone:801-724-6500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEW AHC HOLDINGS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-01-22
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
465170Medicare Oscar/Certification