Summit Lodge Recovery Center
Organization Active NPI Substance Abuse Rehabilitation Facility · Fairview, UT
NPI 1831374768 · NPPES record last updated Jan 9, 2008
Key facts
- NPI
- 1831374768
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Substance Abuse Rehabilitation Facility 324500000X
- License
- 13564 (UT)
- Legal business name
- SUMMIT LODGE RECOVERY CENTER
- Practice address
- RR 1 Box 73B
Fairview, UT 84629-9505 - Phone
- (435) 427-8808
- NPI assigned
- Jan 9, 2008
- Organization subpart
- No
Authorized official
- Name
- Dr. Joel Hanson, M.D.
- Title
- Administrator
- Phone
- (435) 427-8808
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Substance Abuse Rehabilitation Facility | 324500000X | 13564 | UT | Yes |
Addresses
Primary practice location
RR 1 Box 73B
Fairview, UT 84629-9505
Mailing address
RR 1 Box 73B
Fairview, UT 84629-9505
Phone (435) 427-8808
Other providers in Fairview, UT
- Pine Ridge Behavioral Health LLC
- William D Pollock
- Michael L Ratell
- Rural Counseling Associates LLC
- Steven R. Bench, DDS PC
- Katelynne Watts
All providers in Fairview, 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 Jan 9, 2008. 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.