Organization
SALT CREEK ADDICTION RECOVERY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN ROGER BAILEY CMCH (DIRECTOR/OWNER)
(435) 262-0891
Entity
Organization
Contact information
Practice address
21360 N 1450 E, MORONI, UT 84646
(435) 262-0891
Mailing address
PO BOX 316, MORONI, UT 84646
(435) 262-0891
Taxonomy
Speciality
Code
Description
License number
State
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary
15W91838
UT
Other
Enumeration date
04/10/2015
Last updated
04/10/2015
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