OrganizationActive
Country Pines Phase II Lc
NPI 1104037563 · Assisted Living Facility · Clinton, UT
Provider details
- NPI number
- 1104037563
- Entity type
- Organization
- Primary specialty
- Assisted Living FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Myrna Mcclellan, Administrator(801) 773-0990
- License
- 006871 (UT)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
1706 W 1800 N
Clinton, UT 84015-8324
Phone: (801) 773-0990
Approximate (ZIP-level) locationGet directions
Mailing address
1706 W 1800 N
Clinton, UT 84015-8324
Registry dates
- Enumerated
- 2007-05-25
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.