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Lighthouse Ranch Corporation

Organization Active NPI Substance Abuse Rehabilitation Facility · Ephraim, UT

NPI 1992079099 · NPPES record last updated Jul 21, 2022

Key facts

NPI
1992079099
Entity type
Organization (NPI type 2)
Primary specialty
Substance Abuse Rehabilitation Facility 324500000X
Legal business name
LIGHTHOUSE RANCH CORPORATION
Practice address
390 East 100 South
Ephraim, UT 84627
Phone
(435) 283-5200
NPI assigned
Mar 7, 2012
Organization subpart
No

Authorized official

Name
Kevin Bailey NPI 1548562838
Title
Program Director
Phone
(435) 262-0891

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Corporate family (same tax ID) 5

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

Practitioners 33

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 33

National Provider Directory

Tax ID family
Blue Hills Residential Treatment (6 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X UT Yes

Addresses

Primary practice location

390 East 100 South
Ephraim, UT 84627

Mailing address

PO Box 461
Moroni, UT 84646
Phone (435) 445-5200

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 21, 2022.

{
    "created_epoch": "1331078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1992079099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 461",
            "city": "MORONI",
            "state": "UT",
            "postal_code": "84646",
            "telephone_number": "435-445-5200",
            "fax_number": "435-445-5201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 EAST 100 SOUTH",
            "city": "EPHRAIM",
            "state": "UT",
            "postal_code": "84627",
            "telephone_number": "435-283-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE RANCH CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-07",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "435-262-0891"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "UT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ephraim, UT

All providers in Ephraim, UT · Substance Abuse Rehabilitation Facility in Utah

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