Organization · Type 2 NPI

Peak Medical Peachtree, Inc.

Assisted Living Facility · Brigham City, UT

NPI number 1144275587 Active

Practice location

985 S 800 W
Brigham City, UT 84302-3042

Call (435) 723-1394 Map

Fax (435) 723-1416

Mailing address

101 Sun Ave NE, Compliance Department
Albuquerque, NM 87109-4373

Specialties and licenses

Taxonomy	Code	License
Assisted Living Facility	310400000X	2004ALI47536 (UT)
Assisted Living Facility Primary	310400000X	2004ALII7538 (UT)

Assisted Living Facility: A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

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NPI record

NPI: 1144275587
Entity type: Organization (Type 2)
Issued: May 24, 2006
Last updated: Sep 28, 2009
Status: Active
Subpart: Yes of Sunbridge Healthcare Corporation

Other names

<unavail>
Country Lane Assisted Living · doing business as

Authorized official

William A. Mathies
President Director
(505) 821-3355

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1144275587

Peak Medical Peachtree, Inc.'s National Provider Identifier is 1144275587, issued on May 24, 2006. The primary taxonomy on file is Assisted Living Facility (310400000X), and the practice location is in Brigham City, UT. The record was last updated on Sep 28, 2009.