Doctor Name: | CASS CARROL MILLER |
NPI Number: | 1124186218 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 464 S Main St Tooele, UT - 840742748 |
Business Phone Number: | 4358330202 |
Business Fax Number: | |
Mailing Address: | 2816 W 6050 S, ROY |
State: | UT |
Postal Code: | 840671054 |
Phone Number: | 8017748953 |
Fax Number: | |
NPI Enumeration Date: | 12/04/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 310400000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
Taxonomy Type: | Nursing & Custodial Care Facilities |
Taxonomy Classification: | Assisted Living Facility |
Taxonomy Specialization: | |
Taxonomy Definition: | 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. |