Thistle Creek Ranch

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

4381 Issued in UT

Legal business name

THISTLE CREEK RANCH

Practice address

14048 South Highway 89
Spanish Fork, UT 84660

Phone

(801) 873-3199

Fax

(801) 873-3507

NPI assigned

Dec 12, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Seth Riddle, M.D.

Title

Owner

Phone

(801) 362-4900

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1386806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386806400000",
    "number": "1356772537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 542",
            "city": "SPANISH FORK",
            "state": "UT",
            "postal_code": "846600542",
            "telephone_number": "801-873-3199",
            "fax_number": "801-873-3507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14048 SOUTH HIGHWAY 89",
            "city": "SPANISH FORK",
            "state": "UT",
            "postal_code": "84660",
            "telephone_number": "801-873-3199",
            "fax_number": "801-873-3507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THISTLE CREEK RANCH",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-12",
        "last_updated": "2013-12-12",
        "status": "A",
        "authorized_official_last_name": "RIDDLE",
        "authorized_official_first_name": "SETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-362-4900",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "UT",
            "license": "4381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tellica Imaging, LLC
• Jason Andrew Tepper
• David Adam Tervort, DPT
• The Arise Society
• The Marriage and Family Clinic
• Thistle Mountain Recovery
• Brian Mark Thomas, LCSW
• Brooke Thomas
• Tiffany Thomas, RN
• Julie Nicole Thompson, RN

• Substance Abuse Rehabilitation Facility in Spanish Fork, UT
• Providers in Spanish Fork, UT by specialty
• Substance Abuse Rehabilitation Facility in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.