Provider Demographics
NPI:1174075535
Name:LYNX ASSISTED LIVING
Entity type:Organization
Organization Name:LYNX ASSISTED LIVING
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:NUFFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-893-2503
Mailing Address - Street 1:322 N 2375 W
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-5885
Mailing Address - Country:US
Mailing Address - Phone:801-893-2503
Mailing Address - Fax:801-660-1441
Practice Address - Street 1:322 N 2375 W
Practice Address - Street 2:
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-5885
Practice Address - Country:US
Practice Address - Phone:801-893-2503
Practice Address - Fax:801-660-1441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-01
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2016-ALII-UT000479310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility