Provider Demographics
NPI:1942742234
Name:ALAMO ONE INC.
Entity Type:Organization
Organization Name:ALAMO ONE INC.
Other - Org Name:BEEHIVE HOMES OF MAGNA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:F
Authorized Official - Last Name:MICKELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-599-2365
Mailing Address - Street 1:4614 S 2200 W
Mailing Address - Street 2:
Mailing Address - City:TAYLORSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84129-6052
Mailing Address - Country:US
Mailing Address - Phone:801-599-2365
Mailing Address - Fax:
Practice Address - Street 1:3346 S 8000 W
Practice Address - Street 2:
Practice Address - City:MAGNA
Practice Address - State:UT
Practice Address - Zip Code:84044-1948
Practice Address - Country:US
Practice Address - Phone:801-599-2365
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-17
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2016-ALI-UT207186310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility