Provider Demographics
NPI:1558905505
Name:ANNIES ELDER CARE
Entity Type:Organization
Organization Name:ANNIES ELDER CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SUNIMAL
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-797-1107
Mailing Address - Street 1:203 E 1300 S
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84115-5418
Mailing Address - Country:US
Mailing Address - Phone:801-797-1107
Mailing Address - Fax:
Practice Address - Street 1:203 E 1300 S
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84115-5418
Practice Address - Country:US
Practice Address - Phone:801-797-1107
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-03
Last Update Date:2019-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care