NPIMap

Organization Active NPI

Cross Creek Manor

  • Children's Substance Abuse Rehabilitation Facility
  • La Verkin, UT
National Provider Identifier
1780900464
Registry record updated Apr 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Children's Substance Abuse Rehabilitation FacilityTaxonomy code 3245S0500X
Legal business name
CROSS CREEK MANOR
Practice address
50 S State St
La Verkin, UT 84745-5443
Phone
(435) 635-2390
Fax
(435) 635-2778
NPI assigned
Apr 20, 2010
Last updated
Apr 20, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2010

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

Authorized official

Name
Derrick Esplin
Title
Cpa
Phone
(435) 635-2390

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X UT
Psychiatric Residential Treatment Facility 323P00000X UT
Children's Substance Abuse Rehabilitation Facility 3245S0500X UT Primary

Addresses

Primary practice location

50 S State St
La Verkin, UT 84745-5443

Mailing address

50 S State St
La Verkin, UT 84745-5443
Phone (435) 635-2390

National Provider Directory

National Provider Directory
Tax ID family
Cross Creek Manor2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1271721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271721600000",
    "number": "1780900464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 S STATE ST",
            "city": "LA VERKIN",
            "state": "UT",
            "postal_code": "847455443",
            "telephone_number": "435-635-2390",
            "fax_number": "435-635-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 S STATE ST",
            "city": "LA VERKIN",
            "state": "UT",
            "postal_code": "847455443",
            "telephone_number": "435-635-2390",
            "fax_number": "435-635-2778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSS CREEK MANOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-20",
        "last_updated": "2010-04-20",
        "status": "A",
        "authorized_official_last_name": "ESPLIN",
        "authorized_official_first_name": "DERRICK",
        "authorized_official_title_or_position": "CPA",
        "authorized_official_telephone_number": "435-635-2390"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "UT",
            "license": null,
            "primary": false
        },
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "UT",
            "license": null,
            "primary": false
        },
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": "UT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Verkin, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2010; 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.