Medallion Supported Living-Payson

NPI #1043518145 in Payson, Utah

Provider Information

NPI Number: 1043518145
Entity Type: Organization
Organization Name: Medallion Supported Living-Payson
Primary Specialty: Intermediate Care Facility, Intellectual Disabilities
Enumeration Date: Mar 14, 2011
Last Updated: Mar 14, 2011

Practice Location

Address: 2192 W STATE RD
City: Payson
State: Utah
ZIP Code: 84651-4539
Phone: (801) 375-2710

Authorized Official

Name: MR. MERLIN MOYES JR.
Title: OWNER
Phone: (801) 375-2710

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Intermediate Care Facility, Intellectual Disabilities	315P00000X	Primary

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