Provider Demographics
NPI:1154471050
Name:RED ROCK CENTER FOR INDEPENDENCE
Entity Type:Organization
Organization Name:RED ROCK CENTER FOR INDEPENDENCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:OWENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-673-7501
Mailing Address - Street 1:515 W 300 N
Mailing Address - Street 2:SUITE A
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-4578
Mailing Address - Country:US
Mailing Address - Phone:435-673-7501
Mailing Address - Fax:435-673-8808
Practice Address - Street 1:515 W 300 N
Practice Address - Street 2:SUITE A
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-4578
Practice Address - Country:US
Practice Address - Phone:435-673-7501
Practice Address - Fax:435-673-8808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health