| Moonlight Mountain Recovery, Inc | |
|
5230 W Moonlight Mine Rd Pocatello ID 83201-9013 | |
| (208) 505-9990 | |
| Not Available |
| Full Name | Moonlight Mountain Recovery, Inc |
|---|---|
| Speciality | Substance Abuse Rehabilitation Facility |
| Location | 5230 W Moonlight Mine Rd, Pocatello, Idaho |
| Authorized Official Name and Position | Wade Morden (OWNER) |
| Authorized Official Contact | 2085059990 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Moonlight Mountain Recovery, Inc 2154 E 1340 S Heber City UT 84032-1248 Ph: () - | Moonlight Mountain Recovery, Inc 5230 W Moonlight Mine Rd Pocatello ID 83201-9013 Ph: (208) 505-9990 |
| NPI Number | 1861983413 |
|---|---|
| Provider Enumeration Date | 05/18/2018 |
| Last Update Date | 01/13/2021 |
| Certification Date | 01/13/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861983413 | NPI | - | NPPES |
| 1 | Other | ID | CERTIFICATE OF APPROVAL |
Allies Family Solutions Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 850 E Lander St, Pocatello, ID 83201 Phone: 208-234-2094 Fax: 208-234-2637 | |
Lighthouse For Recovery, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1135 Yellowstone Ave, Suite D, Pocatello, ID 83201 Phone: 208-232-2908 Fax: 208-232-5423 | |
Apex Professional Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 611 Wilson Ave, Suite C-3, Pocatello, ID 83201 Phone: 208-904-0225 Fax: 866-704-4580 | |
Behavioral Reform Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1135 Yellowstone Ave Ste D, Pocatello, ID 83201 Phone: 208-238-9400 Fax: 208-238-9401 | |
Psychological Assessment Specialists Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1246 Yellowstone Ave Ste C5, Pocatello, ID 83201 Phone: 208-233-0150 Fax: 208-233-0159 | |
Broncho Mental Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 772 E Ross Fork Road #41, Pocatello, ID 83202 Phone: 208-220-7520 | |
A To Z Family Services Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 732 Washington Ave, Pocatello, ID 83201 Phone: 208-478-9822 Fax: 208-478-6790 |