Provider Demographics
NPI:1689842320
Name:BEE HIVE HOMES OF UTAH VALLEY SOUTH, INC.
Entity Type:Organization
Organization Name:BEE HIVE HOMES OF UTAH VALLEY SOUTH, INC.
Other - Org Name:BEE HIVE HOMES OF OREM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:COTTLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-367-3669
Mailing Address - Street 1:1725 CHEROKEE DR
Mailing Address - Street 2:
Mailing Address - City:PLEASANT GROVE
Mailing Address - State:UT
Mailing Address - Zip Code:84062-3322
Mailing Address - Country:US
Mailing Address - Phone:801-367-3669
Mailing Address - Fax:801-785-9320
Practice Address - Street 1:92 S 800 E
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84097-5714
Practice Address - Country:US
Practice Address - Phone:801-367-3669
Practice Address - Fax:801-224-1374
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-15
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility