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Medallion Supported Living-payson
Intellectual Disabilities Intermediate Care Facility in Payson, Utah
NPI 1043518145

Medallion Supported Living-payson is a Intellectual Disabilities Intermediate Care Facility based in Provo, UT. Medallion Supported Living-payson practices in Payson, UT. The NPI Number for Medallion Supported Living-payson is 1043518145 and holds a License No. 2011-SHCF-100069 (Utah).

The current practice location address for Medallion Supported Living-payson is 2192 W State Rd, Payson, UT and can be reached out via phone at 801-375-2710 and via fax at 801-377-3651.

Location: 2192 W State Rd, Payson, UT, 84605-1377
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1043518145
Provider Name
Medallion Supported Living-payson
Credential
Provider Entity Type
Organization
Address
2192 W State Rd, Payson, UT, 84605-1377
Phone Number
801-375-2710
Fax Number
801-377-3651
Provider Enumeration Date
03/14/2011
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
2192 W State Rd
City
Payson
State
Utah
Zip
84651-4539
Phone Number
801-375-2710
Fax Number
801-377-3651
person
Provider Business Mailing Address Details
Address
2192 W State Rd
City
Payson
State
Utah
Zip
84651-4539
Phone Number
801-375-2710
Fax Number
801-377-3651
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Intermediate Care Facility, Mentally Retarded
Speciality
-
Taxonomy
315P00000X
License No.
2011-SHCF-100069 (Utah)
Definition
(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.
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