Provider Demographics
NPI:1841893120
Name:ST. GEORGE SENIOR CARE
Entity type:Organization
Organization Name:ST. GEORGE SENIOR CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:BRYAN
Authorized Official - Last Name:EMETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-628-0555
Mailing Address - Street 1:352 E RIVERSIDE DR STE B4
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-5808
Mailing Address - Country:US
Mailing Address - Phone:435-628-0555
Mailing Address - Fax:
Practice Address - Street 1:352 E RIVERSIDE DR STE B4
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-5808
Practice Address - Country:US
Practice Address - Phone:435-628-0555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-18
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care