Provider Demographics
NPI:1376093765
Name:STEPS RECOVERY CENTER ST. GEORGE
Entity Type:Organization
Organization Name:STEPS RECOVERY CENTER ST. GEORGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:JORGENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:801-465-5111
Mailing Address - Street 1:1085 S BLUFF ST
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-5245
Mailing Address - Country:US
Mailing Address - Phone:435-673-1086
Mailing Address - Fax:801-405-2363
Practice Address - Street 1:996 W 800 S
Practice Address - Street 2:
Practice Address - City:PAYSON
Practice Address - State:UT
Practice Address - Zip Code:84651-2766
Practice Address - Country:US
Practice Address - Phone:801-658-5501
Practice Address - Fax:801-465-7762
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STEPS RECOVERY CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-10-10
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT15432324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility