| Eagle Ranch Outpatient Services | |
|
91 W 1470 S Suite 101 St George UT 84770-6709 | |
| (435) 652-8488 | |
| Not Available |
| Full Name | Eagle Ranch Outpatient Services |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 91 W 1470 S, St George, Utah |
| Authorized Official Name and Position | Kelly Bawden (CLINICAL DIRECTOR) |
| Authorized Official Contact | 4359220440 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eagle Ranch Outpatient Services 91 W 1470 S Suite 101 St George UT 84770-6709 Ph: (435) 652-8488 | Eagle Ranch Outpatient Services 91 W 1470 S Suite 101 St George UT 84770-6709 Ph: (435) 652-8488 |
| NPI Number | 1386194751 |
|---|---|
| Provider Enumeration Date | 10/10/2016 |
| Last Update Date | 10/10/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386194751 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 53606263904 (Utah) | Secondary |
| 251S00000X | Community/behavioral Health | 5360626 3904 (Utah) | Primary |
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