Provider Demographics
NPI:1881335347
Name:AMANA CARE
Entity type:Organization
Organization Name:AMANA CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MONA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALFARDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-499-2990
Mailing Address - Street 1:3161 S WEST TEMPLE UNIT 65944
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84165-6539
Mailing Address - Country:US
Mailing Address - Phone:385-202-1929
Mailing Address - Fax:
Practice Address - Street 1:3848 S WEST TEMPLE APT 362
Practice Address - Street 2:
Practice Address - City:SOUTH SALT LAKE
Practice Address - State:UT
Practice Address - Zip Code:84115-1293
Practice Address - Country:US
Practice Address - Phone:385-202-1929
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-06
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care