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General NPI Number Information
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NPI Number | 1871307942
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Entity Type | Organization
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Legal Business Name | CASCADE LODGE
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Dates
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Enumeration Date | 02/06/2025
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Last Update Date | 02/06/2025
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Provider Practice Location Address
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Address Line | 9091 E 100 S
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City | HUNTSVILLE
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State | UT
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Zip | 84317-9608
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Country | US
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Telephone | 435-562-5800
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1145
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City | MIDWAY
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State | UT
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Zip | 84049-1145
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Country | US
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Telephone | 801-895-0323
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | BEKAH SCHULER
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Credential | CMHC
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Telephone | 801-694-9306
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number |
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License Number State |
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