Organization
LIGHTHOUSE RANCH CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN BAILEY (PROGRAM DIRECTOR)
(435) 262-0891
Entity
Organization
Contact information
Practice address
390 EAST 100 SOUTH, EPHRAIM, UT 84627
(435) 283-5200
Mailing address
PO BOX 461, MORONI, UT 84646
(435) 445-5200
(435) 445-5201
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
UT
Other
Enumeration date
03/07/2012
Last updated
07/21/2022
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