Lighthouse Ranch

NPI #1982972964 in Moroni, Utah

Provider Information

NPI Number: 1982972964
Entity Type: Organization
Organization Name: Lighthouse Ranch
Primary Specialty: Substance Abuse Rehabilitation Facility - Substance Abuse Treatment, Children
Enumeration Date: Dec 6, 2011
Last Updated: Dec 6, 2011

Practice Location

Address: 21360 N 1450 E
City: Moroni
State: Utah
ZIP Code: 84646-0461
Phone: (435) 445-5200

Authorized Official

Name: KEVIN ROGER BAILEY
Title: PROGRAM DIRECTOR
Phone: (435) 262-0891

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Substance Abuse Rehabilitation Facility - Substance Abuse Treatment, Children — Substance Abuse Treatment, Children	3245S0500X	Primary

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