Moonlight Mountain Recovery, INC
NPI #1861983413 in Pocatello, Idaho
Provider Information
- NPI Number
- 1861983413
- Entity Type
- Organization
- Organization Name
- Moonlight Mountain Recovery, INC
- Primary Specialty
- Substance Abuse Rehabilitation Facility
- Enumeration Date
- May 18, 2018
- Last Updated
- Jan 13, 2021
Practice Location
Authorized Official
- Name
- WADE MORDEN
- Title
- OWNER
- Phone
- (208) 505-9990
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