Provider Demographics
NPI:1275962276
Name:KVD CARE
Entity Type:Organization
Organization Name:KVD CARE
Other - Org Name:HEART & HOME ASSISTED LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KYM
Authorized Official - Middle Name:
Authorized Official - Last Name:BRONSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:801-706-7600
Mailing Address - Street 1:41 E CENTER ST
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84014-2244
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:801-335-4911
Practice Address - Street 1:41 E CENTER ST
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:UT
Practice Address - Zip Code:84014-2244
Practice Address - Country:US
Practice Address - Phone:801-677-0179
Practice Address - Fax:801-335-4911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-11
Last Update Date:2013-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2013-AL1-UT000332310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility