Red Circle Lodge, INC

NPI #1083107320 in Hildale, Utah

Provider Information

NPI Number: 1083107320
Entity Type: Organization
Organization Name: Red Circle Lodge, INC
Primary Specialty: Substance Abuse Rehabilitation Facility - Substance Abuse Treatment, Children
Enumeration Date: Jun 12, 2018
Last Updated: Jun 12, 2018

Practice Location

Address: 930 N MEMORIAL ST
City: Hildale
State: Utah
ZIP Code: 84784
Phone: (435) 874-1467

Authorized Official

Name: LANE SHEPHERD, M.ED., LCMHC
Title: CLINICAL DIRECTOR
Phone: (435) 229-9437

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Residential Treatment Facility, Emotionally Disturbed Children	322D00000X
Substance Abuse Rehabilitation Facility - Substance Abuse Treatment, Children — Substance Abuse Treatment, Children	3245S0500X	Primary

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