THATCHER BROOK REHABILITATION AND CARE CENTER LLC - NPI 1649454703 - Nursing Facility/Intermediate Care Facility in Clearfield, UT

Q: What is Thatcher Brook Rehabilitation And Care Center LLC's specialty?

The primary specialty registered for this NPI is Nursing Facility/Intermediate Care Facility with taxonomy code 313M00000X.

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About Thatcher Brook Rehabilitation And Care Center Llc NPPES

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

THATCHER BROOK REHABILITATION AND CARE CENTER LLC (NPI 1649454703) is a healthcare organization registered as a nursing facility/intermediate care facility in Clearfield, Utah and active in the NPI registry since December 2007. The organization holds a CLIA Waiver certificate valid through December 27, 2026 and lists Deven B Pettit, Administrator/owner, as its authorized official.

NPPES Registry Identity

NPI1649454703

Entity TypeOrganization

Primary Taxonomy313M00000X

Legal Business NameTHATCHER BROOK REHABILITATION AND CARE CENTER LLC

Location Address1795 CHELEMES WAYClearfield, UT 84015-6298

Mailing AddressPo Box 160528Clearfield, UT 84016 · (801) 614-5700 · Fax (801) 614-5750

Phone(801) 614-5700

Fax(801) 614-5750

Organization SubpartNo

Authorized OfficialDeven B PettitAdministrator/owner · (801) 614-5700

Enumeration DateDecember 26, 2007

Last NPPES UpdateFebruary 10, 2015

✔ NPI 1649454703 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNursing Facility/Intermediate Care FacilityNursing & Custodial Care Facilities

Taxonomy Code313M00000X

Definition

An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals.

1795 CHELEMES WAY, Clearfield, UT 84015

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Other Identifiers 2

Medicare OSCAR/certification465169UT

Medicare PIN465169UT

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Select Health.Insurance ›

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 46D1083190

Thatcher Brook Rehabilitation And Care Center · Clearfield, UT

Active · expires Dec 27, 2026

CLIA Number46D1083190

Laboratory TypeSkilled Nursing Facility/Nursing Facility

Certificate Effective DateDecember 28, 2024

Certificate Expiration DateDecember 27, 2026

Laboratory DirectorDeven B. Pettit

Laboratory Phone(801) 614-5700

Laboratory LocationThatcher Brook Rehabilitation And Care Center1795 S Chelemes Way, Clearfield, UT 84015

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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