Legacy Outdoor Adventures LLC
NPI #1245509918 in Loa, Utah
Provider Information
- NPI Number
- 1245509918
- Entity Type
- Organization
- Organization Name
- Legacy Outdoor Adventures LLC
- Primary Specialty
- Substance Abuse Rehabilitation Facility
- Enumeration Date
- Dec 23, 2011
- Last Updated
- Dec 23, 2011
Practice Location
Authorized Official
- Name
- MR. GILBERT HALLOWS
- Title
- EXECUTIVE DIRECTOR
- Phone
- (435) 836-2272
Specialties & Taxonomy Codes
| Specialty |
|---|
| Substance Abuse Rehabilitation Facility |
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