Provider Demographics
NPI:1437338316
Name:SOUTH VALLEY TRANSITIONAL CARE CENTER, LLC
Entity Type:Organization
Organization Name:SOUTH VALLEY TRANSITIONAL CARE CENTER, LLC
Other - Org Name:STONEWOOD VILLA ASSISTED LIVING OR STONEWOOD VILLA NURSING & REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:LINN
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-226-4343
Mailing Address - Street 1:410 S MAIN ST
Mailing Address - Street 2:430 S MAIN ST
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84058-6202
Mailing Address - Country:US
Mailing Address - Phone:801-226-4343
Mailing Address - Fax:801-426-5670
Practice Address - Street 1:410 S MAIN ST
Practice Address - Street 2:430 S MAIN ST
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84058-6202
Practice Address - Country:US
Practice Address - Phone:801-226-4343
Practice Address - Fax:801-426-5670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-29
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1995-11986310400000X
UT1993-10851314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility