| Hobble Creek Behavioral Health | |
|
51 East 800 North Spanish Fork UT 84660-1210 | |
| (435) 314-9623 | |
| (385) 200-5520 |
| Full Name | Hobble Creek Behavioral Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 51 East 800 North, Spanish Fork, Utah |
| Authorized Official Name and Position | Robert Chris Wilkins (OWNER) |
| Authorized Official Contact | 8013181882 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hobble Creek Behavioral Health 51 East 800 North Spanish Fork UT 84660-1210 Ph: (801) 318-1882 | Hobble Creek Behavioral Health 51 East 800 North Spanish Fork UT 84660-1210 Ph: (435) 314-9623 |
| NPI Number | 1083264907 |
|---|---|
| Provider Enumeration Date | 09/12/2019 |
| Last Update Date | 01/25/2022 |
| Certification Date | 01/25/2022 |
| Medicare PECOS PAC ID | 8921449034 |
|---|---|
| Medicare Enrollment ID | O20240906001611 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083264907 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Robert Chris Wilkins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609232388 PECOS PAC ID: 4284973678 Enrollment ID: I20190301000627 |
| Provider Name | Jentry Mckell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508460841 PECOS PAC ID: 2668859117 Enrollment ID: I20220523000512 |
| Provider Name | Kristi Everett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417333717 PECOS PAC ID: 4385939859 Enrollment ID: I20241003002262 |
| Provider Name | Christy Long |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902228232 PECOS PAC ID: 2961933734 Enrollment ID: I20241003002390 |
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