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COUNTRY PINES PHASE II LC
NPI 1104037563
Assisted Living Facility in Clinton, UT

Active since May 25, 2007
1706 W 1800 N, CLINTON, UT 84015(801) 773-0990 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Country Pines Phase Ii Lc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COUNTRY PINES PHASE II LC (NPI 1104037563) is a healthcare organization registered as an assisted living facility in Clinton, Utah and active in the NPI registry since May 2007. The organization lists Myrna L Mcclellan, Administrator, as its authorized official.

NPPES Registry Identity

NPI1104037563
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameCOUNTRY PINES PHASE II LC
Location Address1706 W 1800 NClinton, UT 84015-8324
Mailing Address1706 W 1800 NClinton, UT 84015-8324 · (801) 773-0990
Phone(801) 773-0990
Organization SubpartNo
Authorized OfficialMyrna L McclellanAdministrator · (801) 773-0990
Enumeration DateMay 25, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1104037563 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
License✔ Licensed in UT · 006871
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
1706 W 1800 N, Clinton, UT 84015
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Country Pines Phase II Lc's NPI number?

The NPI number for Country Pines Phase II Lc is 1104037563. It was assigned to this organization in the NPPES registry on May 25, 2007.

Where is Country Pines Phase II Lc located?

Country Pines Phase II Lc is located at 1706 W 1800 N, Clinton, UT 84015. The listed phone number is (801) 773-0990.

What is Country Pines Phase II Lc's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

When was this NPI record last updated?

The NPPES record for Country Pines Phase II Lc was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.