Provider Demographics
NPI:1619208550
Name:THE COVENTRY
Entity Type:Organization
Organization Name:THE COVENTRY
Other - Org Name:THE COVENTRY AT COTTONWOOD HEIGHTS
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUITVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DEVIN
Authorized Official - Middle Name:S
Authorized Official - Last Name:ALLRED
Authorized Official - Suffix:
Authorized Official - Credentials:HFA, CMCA, CAM
Authorized Official - Phone:801-943-5858
Mailing Address - Street 1:6898 S 2300 E
Mailing Address - Street 2:
Mailing Address - City:SLC
Mailing Address - State:UT
Mailing Address - Zip Code:84121-3195
Mailing Address - Country:US
Mailing Address - Phone:801-943-5858
Mailing Address - Fax:801-943-8009
Practice Address - Street 1:6898 S 2300 E
Practice Address - Street 2:
Practice Address - City:SLC
Practice Address - State:UT
Practice Address - Zip Code:84121-3195
Practice Address - Country:US
Practice Address - Phone:801-943-5858
Practice Address - Fax:801-943-8009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-15
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility