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Medallion Manor Inc.
Intellectual Disabilities Intermediate Care Facility in Provo, Utah
NPI 1720098163

Medallion Manor Inc. is a Intellectual Disabilities Intermediate Care Facility based in Provo, UT. Medallion Manor Inc. practices in Provo, UT. The NPI Number for Medallion Manor Inc. is 1720098163 and holds a License No. 2006-NCF-69 (Utah).

The current practice location address for Medallion Manor Inc. is 1701 W 600 S, Provo, UT and can be reached out via phone at 801-375-2710.

Location: 1701 W 600 S, Provo, UT, 84605-1377
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1720098163
Provider Name
Medallion Manor Inc.
Credential
Provider Entity Type
Organization
Address
1701 W 600 S, Provo, UT, 84605-1377
Phone Number
801-375-2710
Fax Number
Provider Enumeration Date
08/08/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
1701 W 600 S
City
Provo
State
Utah
Zip
84601-3832
Phone Number
801-375-2710
Fax Number
person
Provider Business Mailing Address Details
Address
1701 W 600 S
City
Provo
State
Utah
Zip
84601-3832
Phone Number
801-375-2710
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Intermediate Care Facility, Mentally Retarded
Speciality
-
Taxonomy
315P00000X
License No.
2006-NCF-69 (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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