| Organization Name: | WILLOW CREEK HOSPICE OF UTAH, L.L.C. |
| NPI Number: | 1306083159 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TRACE D. OSBORNE (MANAGER) |
| Mailing Address: | 5200 S Highland Dr Suite 200 Holladay |
| State: | UT US |
| Postal Code: | 841177057 |
| Phone Number: | 8012773298 |
| Fax Number: | 8012773598 |
| NPI Enumeration Date: | 01/15/2009 |
| NPI Last Update Date: | 02/21/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251G00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Hospice Care, Community Based |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |