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Organization

CIRQUE LODGE INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GARY FISHER (DIRECTOR OF OPERATIONS)
(801) 222-9200
Entity
Organization

Contact information

Practice address
777 N PALISADES DR, OREM, UT 84097-4341
(801) 222-9200
(801) 222-0112
Mailing address
777 N PALISADES DR, OREM, UT 84097-4341
(801) 222-9200
(801) 222-0112

Taxonomy

Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
12370
UT

Other

Enumeration date
05/31/2007
Last updated
11/26/2016
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