Provider Demographics
NPI:1174017396
Name:CANYONLANDS HEALTH CARE SPECIAL SERVICE DISTRICT
Entity Type:Organization
Organization Name:CANYONLANDS HEALTH CARE SPECIAL SERVICE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:G
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-489-9191
Mailing Address - Street 1:242 N 200 W
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-2710
Mailing Address - Country:US
Mailing Address - Phone:801-489-9191
Mailing Address - Fax:
Practice Address - Street 1:242 N 200 W
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-2710
Practice Address - Country:US
Practice Address - Phone:801-489-9191
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CANYONLANDS HEALTH CARE SPECIAL SERVICE DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-06-20
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility