OrganizationActive
Life Care Community LLC
NPI 1487441937 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · South Jordan, UT
Provider details
- NPI number
- 1487441937
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Venant Bigwi, Executive Director(385) 420-1249
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000X
Residential Treatment Facilities
Practice location
4373 W Lennox Dr
South Jordan, UT 84009-9786
Phone: (385) 420-1249
Approximate (ZIP-level) locationGet directions
Mailing address
4373 W Lennox Dr
South Jordan, UT 84009-9786
Registry dates
- Enumerated
- 2025-04-21
- Last updated
- 2025-04-21
- Certified
- 2025-04-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.