NPI: 1669924692 · SPANISH FORK, UT 84660 · Assisted Living Facility · NPI assigned 10/25/2016
| Authorized Official | HERMANSEN, CRAIG (OWNER) |
| NPI Enumeration Date | 10/25/2016 |
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 24 | $57K |
| 2024 | 143 | $331K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| T2031 | Assisted living; waiver, per diem | 167 | 164 | $388K |