Organization
LIGHTHOUSE RANCH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TODD PAY (OWNER)
(435) 851-1824
Entity
Organization
Contact information
Practice address
21360 NORTH 1450 EAST, MORONI, UT 84646-0461
(435) 851-1824
Mailing address
21360 N. 1450 E., MORONI, UT 84646-0461
(435) 851-1824
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
32253J00000X
UT
Other
Enumeration date
05/26/2010
Last updated
05/26/2010
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