Michael David Hassler
Individual provider Active NPI Substance Abuse Rehabilitation Facility · Moroni, UT
NPI 1043592637 · NPPES record last updated Sep 9, 2011
Key facts
- NPI
- 1043592637
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Substance Abuse Rehabilitation Facility 324500000X
- License
- 1235458555 (UT)
- Practice address
- 21260 North 1450 East
Moroni, UT 84646-0461 - Phone
- (435) 445-5200
- Fax
- (435) 445-5201
- NPI assigned
- Sep 9, 2011
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1235458555 | UT | MD | Substance Abuse Rehabilitation Facility |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Substance Abuse Rehabilitation Facility | 324500000X | 1235458555 | UT | Yes |
Addresses
Primary practice location
21260 North 1450 East
Moroni, UT 84646-0461
Mailing address
PO Box 461
21260 North 1450 East
Moroni, UT 84646-0461
Phone (435) 445-5200
Other providers in Moroni, UT
- Juan Carlos Grillo
- Michael Raymond Hamm Jr.
- Trevor Hansen
- Milton Scott Harmon
- Kathy Harward
- Bart Douglas Hennagir
- Bryan Holder
- Boedee Lee Hopes
- Hunter Lee Hopes
- Ihc Health Services Inc
All providers in Moroni, UT · Substance Abuse Rehabilitation Facility in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 9, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.