COTTONWOOD CREEK
NPI 1578850590
Assisted Living Facility in Salt Lake City, UT

Active since June 29, 2011CLIA 46D2196706 · Waiver
1245 MURRAY HOLLADAY RD, SALT LAKE CITY, UT 84117(801) 263-0999(801) 262-4770 Get Directions Write a Review

NPPES record last updated: June 29, 2011. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Cottonwood Creek NPPES

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

COTTONWOOD CREEK (NPI 1578850590) is a healthcare organization registered as an assisted living facility in Salt Lake City, Utah and active in the NPI registry since June 2011. The organization holds a CLIA Waiver certificate valid through October 18, 2026 and lists Lary Simon, Senior Vice President And Cfo, as its authorized official.

NPPES Registry Identity

NPI1578850590
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameCOTTONWOOD CREEK MSL, LLC
Location Address1245 MURRAY HOLLADAY RDSalt Lake City, UT 84117-4992
Mailing Address175 Technology Dr, Ste 200Irvine, CA 92618-2478 · (949) 242-1400
Fax(801) 262-4770
Organization SubpartNo
Authorized OfficialLary SimonSenior Vice President And Cfo · (949) 242-1400
Enumeration DateJune 29, 2011
NPI 1578850590 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 · 2011-ALI-88423
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.

1245 MURRAY HOLLADAY RD, Salt Lake City, UT 84117

Other Names 1

Doing Business AsCottonwood Creek

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 46D2196706

Cottonwood Creek · Salt Lake City, UT
Active · expires Oct 18, 2026
CLIA Number46D2196706
Laboratory TypeAssisted Living Facility
Certificate Effective DateOctober 19, 2024
Certificate Expiration DateOctober 18, 2026
Laboratory DirectorMark Mun
Laboratory Phone(801) 263-0999
Laboratory LocationCottonwood Creek1245 Murray Holladay Rd, Salt Lake City, UT 84117
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Cottonwood Creek Msl, LLC's NPI number?

The NPI number for Cottonwood Creek Msl, LLC is 1578850590. It was assigned to this organization in the NPPES registry on June 29, 2011. The provider is doing business as Cottonwood Creek.

Where is Cottonwood Creek Msl, LLC located?

Cottonwood Creek Msl, LLC is located at 1245 Murray Holladay Rd, Salt Lake City, UT 84117. The listed phone number is (801) 263-0999.

What is Cottonwood Creek Msl, LLC's specialty?

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

Does Cottonwood Creek Msl, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 46D2196706) is associated with this NPI, valid through October 18, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Cottonwood Creek Msl, LLC was last updated on June 29, 2011. NPI Profile syncs with the weekly NPPES data releases published by CMS.