Cross Creek Manor

NPI #1780900464 in La Verkin, Utah

Provider Information

NPI Number: 1780900464
Entity Type: Organization
Organization Name: Cross Creek Manor
Primary Specialty: Substance Abuse Rehabilitation Facility - Substance Abuse Treatment, Children
Enumeration Date: Apr 20, 2010
Last Updated: Apr 20, 2010

Practice Location

Address: 50 S STATE ST
City: La Verkin
State: Utah
ZIP Code: 84745-5443
Phone: (435) 635-2390

Authorized Official

Name: DERRICK ESPLIN
Title: CPA
Phone: (435) 635-2390

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Residential Treatment Facility, Emotionally Disturbed Children	322D00000X
Psychiatric Residential Treatment Facility	323P00000X
Substance Abuse Rehabilitation Facility - Substance Abuse Treatment, Children — Substance Abuse Treatment, Children	3245S0500X	Primary

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