Provider Demographics
NPI:1871476259
Name:SLICKROCK VENTURES, LLC
Entity type:Organization
Organization Name:SLICKROCK VENTURES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-513-4868
Mailing Address - Street 1:10808 S RIVER FRONT PKWY STE 3091
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-5939
Mailing Address - Country:US
Mailing Address - Phone:801-513-4868
Mailing Address - Fax:
Practice Address - Street 1:10808 S RIVER FRONT PKWY STE 3091
Practice Address - Street 2:
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84095-5939
Practice Address - Country:US
Practice Address - Phone:801-513-4868
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-31
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care