Organization Name: | CILANTRO HOLDINGS, LLC |
NPI Number: | 1538447305 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LANCE SQUIRE (ADMINISTRATOR) |
Mailing Address: | 11576 S State St Ste 101a Draper |
State: | UT US |
Postal Code: | 840206431 |
Phone Number: | 8015427384 |
Fax Number: | |
NPI Enumeration Date: | 07/28/2011 |
NPI Last Update Date: | 07/28/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251G00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Hospice Care, Community Based |
Taxonomy Specialization: | |
Taxonomy Definition: |