Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Medallion Manor Inc

Organization Intellectual Disabilities Intermediate Care Facility · NPI 1720098163

Medallion Manor Inc is an Intellectual Disabilities Intermediate Care Facility in Provo, Utah. Licensed in Utah. Registered with an NPI since 2006.

Licensed in
UT
In the registry since
2006
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1701 W 600 S
Provo, UT 84601-3832
Phone: (801) 375-2710
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Intellectual Disabilities Intermediate Care Facility (primary) Taxonomy 315P00000X · Licence 2006-NCF-69 (UT)

Record details

NPI number1720098163
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Merlin Moyes — Administrator · (801) 375-2710
NPI enumeratedAugust 8, 2006
Last updated in NPPESAugust 22, 2020
Mailing addressPo Box 51377, Provo, UT 84605-1377

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