# MOONRIDGE ACADEMY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407988017
- **Authorized official:** CALLIE BASSETT (OFFICE MANAGER)
- **Authorized official phone:** (435) 586-9585

## Contact information

- **Practice address:** 9450 W 2400 S, CEDAR CITY, UT 84720-6706
- **Practice address phone:** (435) 586-9585
- **Mailing address:** 9450 W 2400 S, CEDAR CITY, UT 84720-6706
- **Mailing address phone:** (435) 586-9585

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 323P00000X | Psychiatric Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 03/09/2007
- **Last updated:** 08/22/2020