Organization
CROSS CREEK MANOR
Active
Organization
CROSS CREEK MANOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DERRICK ESPLIN (CPA)
(435) 635-2390
Entity
Organization
Contact information
Practice address
50 S STATE ST, LA VERKIN, UT 84745-5443
(435) 635-2390
(435) 635-2778
Mailing address
50 S STATE ST, LA VERKIN, UT 84745-5443
(435) 635-2390
(435) 635-2778
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
UT
323P00000X
Psychiatric Residential Treatment Facility
—
UT
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary
—
UT
Other
Enumeration date
04/20/2010
Last updated
04/20/2010
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