| Organization Name: | 3300 SOUTH OPERATING LLC |
| NPI Number: | 1114371564 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARK DANIEL MILLER (CEO MGMT COMPANY) |
| Mailing Address: | 950 E 3300 S Salt Lake City |
| State: | UT US |
| Postal Code: | 841062141 |
| Phone Number: | 8014670060 |
| Fax Number: | |
| NPI Enumeration Date: | 04/21/2016 |
| NPI Last Update Date: | 04/21/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 311500000X |
| License Number: | 2016-ALII-UT000740 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Nursing & Custodial Care Facilities |
| Taxonomy Classification: | Alzheimer Center (Dementia Center) |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A freestanding facility or special care unit of a long term care facility focusing on patient care of individuals diagnosed with dementia or Alzheimer |