Provider Demographics
NPI:1639760291
Name:LARLEE HOLDINGS, INC
Entity Type:Organization
Organization Name:LARLEE HOLDINGS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DON
Authorized Official - Prefix:
Authorized Official - First Name:DEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LARSEN
Authorized Official - Suffix:
Authorized Official - Credentials:BSN
Authorized Official - Phone:801-447-5353
Mailing Address - Street 1:7069 S HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD HEIGHTS
Mailing Address - State:UT
Mailing Address - Zip Code:84121-3724
Mailing Address - Country:US
Mailing Address - Phone:801-447-5353
Mailing Address - Fax:801-447-6886
Practice Address - Street 1:7069 S HIGHLAND DR
Practice Address - Street 2:
Practice Address - City:COTTONWOOD HEIGHTS
Practice Address - State:UT
Practice Address - Zip Code:84121-3724
Practice Address - Country:US
Practice Address - Phone:801-447-5353
Practice Address - Fax:801-447-6886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-27
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care