Provider Demographics
NPI:1053925123
Name:SOUTHERN UTAH HOSPICE AND HOME CARE LLC
Entity type:Organization
Organization Name:SOUTHERN UTAH HOSPICE AND HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MAHOGANI
Authorized Official - Middle Name:
Authorized Official - Last Name:MADRIGAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-635-1001
Mailing Address - Street 1:83 S 2600 W
Mailing Address - Street 2:
Mailing Address - City:HURRICANE
Mailing Address - State:UT
Mailing Address - Zip Code:84737-3266
Mailing Address - Country:US
Mailing Address - Phone:435-635-1001
Mailing Address - Fax:385-313-8450
Practice Address - Street 1:83 S 2600 W
Practice Address - Street 2:
Practice Address - City:HURRICANE
Practice Address - State:UT
Practice Address - Zip Code:84737-3266
Practice Address - Country:US
Practice Address - Phone:435-635-1001
Practice Address - Fax:385-313-8450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-04
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based