- Enrollment id
- O20150513000350
- Enrollment state
- UT
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1598990699
- Multiple npi flag
- N
- Ccn
- 465049
- Associate id
- 2769376326
- Organization name
- BEAVER VALLEY HOSPITAL
- Doing business as name
- SPRING CREEK HEALTHCARE CENTER
- Organization type structure
- GOVERNMENT
- Proprietary nonprofit
- N
- Nursing home provider name
- SPRING CREEK HEALTHCARE CENTER
- Affiliation entity name
- CASCADES HEALTHCARE
- Affiliation entity id
- 117
- Address line 1
- 4600 S HIGHLAND DR
- City
- SALT LAKE CITY
- State
- UT
- Zip code
- 841175108