Provider Demographics
NPI:1831483254
Name:ASHFORD MEMORY CARE, INC
Entity Type:Organization
Organization Name:ASHFORD MEMORY CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:NIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-523-1600
Mailing Address - Street 1:14178 S BANGERTER PKWY
Mailing Address - Street 2:
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84003-8884
Mailing Address - Country:US
Mailing Address - Phone:801-523-1600
Mailing Address - Fax:801-523-1605
Practice Address - Street 1:14178 S BANGERTER PKWY
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84003-8884
Practice Address - Country:US
Practice Address - Phone:801-523-1600
Practice Address - Fax:801-523-1605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-02
Last Update Date:2018-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility