Provider Demographics
NPI:1700191103
Name:WASATCH HOME HEALTH & HOSPICE, LLC
Entity Type:Organization
Organization Name:WASATCH HOME HEALTH & HOSPICE, LLC
Other - Org Name:ABUNDANT LIFE HOME HEALTH & HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:HASLAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-916-1165
Mailing Address - Street 1:710 40TH ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84403-2236
Mailing Address - Country:US
Mailing Address - Phone:801-916-1165
Mailing Address - Fax:
Practice Address - Street 1:710 40TH ST
Practice Address - Street 2:
Practice Address - City:SOUTH OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403-2236
Practice Address - Country:US
Practice Address - Phone:801-916-1165
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-10
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based