ST. GEORGE DETOX CENTER LLC (NPI# 1093189839) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093189839 |
| Entity Type | Organization |
| Organization Name | ST. GEORGE DETOX CENTER LLC |
| Other Organization Name | ST. GEORGE DETOX HOSPITAL |
| Practice Address |
120 W 1470 S Bldg B St George UT 84770-6798 |
| Practice Telephone | 4352720220 |
| Mailing Telephone | 4352720220 |
| Mailing Fax Number | 8016769340 |
| Enumeration Date | 2015-11-17 |
| Last Update Date | 2015-11-17 |
| Authorized Official Name | ARLEN BARKSDALE (OWNER) |
| Authorized Official Telephone | 7605338714 |
| Is Organization Subpart | Y |
| Parent Organization Name | ARBROVITAE ENTERPRISES LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 284300000X | Special Hospital | 2014-HOSP-UT0005 | UT | Hospitals |
| Other Name | Type Code |
|---|---|
| St. George Detox Hospital | Former Legal Business Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | St. George Detox Center LLC | Po Box 156, Lake City, CO 81235 |
| Street Address |
120 W 1470 S BLDG B |
| City | ST GEORGE |
| State | UT |
| Zip Code | 84770-6798 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740808500 | Redstone Reference Laboratories Inc | Clinical Medical Laboratory | 556 N Dixie Drive, Suite 2, St George, UT 84770 | 2020-07-08 |
| 1033776315 | Ecko Ashmore | Marriage & Family Therapist | 1173 S. 250 W. Bld 1 Ste 208, St. George, UT 84770 | 2019-05-22 |
| 1740844679 | Amy Darragh | Behavior Technician | 249 E Tabernacle St, Ste 100, St George, UT 84770 | 2019-04-25 |
| 1124598198 | Loren Kyle Gulbranson | Internal Medicine | Dixie Regional Medical Center, 515 South, 300 East, Saint George, UT 84770 | 2018-12-03 |
| 1487150728 | Sound Sleep Medical LLC | Durable Medical Equipment & Medical Supplies | 640 East 700 South Building 2, St. George, UT 84770 | 2018-04-04 |
| 1588162911 | Desert Edge Medical | Family Medicine | 1664 S Dixie Dr Ste D201, St George, UT 84770 | 2018-01-31 |
| 1568981314 | Jeffrey Joseph Peterson | Behavior Technician | 162 N 400 E Ste A-105, St. George, UT 84770 | 2017-09-13 |
| 1992242549 | Zachary Carey | Specialist/Technologist | 1115 W Diamond Valley Dr, Saint George, UT 84770 | 2017-01-20 |
| 1669920427 | Charles Taylor Church | Technician, Other | 474 West 200 East, St. George, UT 84770 | 2016-09-21 |
| 1952755480 | Hollystic Hideaway | Voluntary or Charitable | 1418 W Sunset Blvd. # 2, Saint George, UT 84770 | 2016-04-21 |
| Find all providers in zip 84770 | ||||
| Taxonomy Code | 284300000X |
| Grouping | Hospitals |
| Classification | Special Hospital |
| A designation by the AHA of a hospital whose primary function of the institution is to provide diagnostic and treatment services for patients who have specified medical conditions, both surgical and nonsurgical. |
| Notes: Source: AHA Guide, Registration section, p. A5. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831505874 | Shadow Mountain LLC. | Special Hospital | 120 W. 1470 South, Building B, St. George, UT 84770 | 2014-07-10 |
| 1063754893 | Trenton Lyle Neal | Special Hospital | 308 W 7200 S, Midvale, UT 84047-1041 | 2013-03-19 |
| 1124208343 | Gateway Aestheetic Institute& Laser Center | Special Hospital | 440 W 200 S Ste 250, Salt Lake City, UT 84101-1462 | 2007-11-05 |
| 1649470113 | New Life Centers | Special Hospital | 1255 E 3900 S Ste 300, Salt Lake City, UT 84124-1389 | 2007-07-23 |
| 1629411020 | Valerie Price | Special Hospital | 9414 S 1335 E, Sandy, UT 84092-2947 | 2013-04-16 |
| 1780926592 | Deborah Deann Rowley | Special Hospital | 308 W 7200 S, Midvale, UT 84047-1041 | 2013-03-19 |
| 1215294228 | Hyrum John Kerbs | Special Hospital | 5848 Fashion Blvd, Murray, UT 84107-6121 | 2012-04-13 |
| 1023306297 | Slc Va Medical Center | Special Hospital | 500 Foothill Drive, Salt Lake City, UT 84148 | 2011-07-21 |
| 1801181631 | University of Utah | Special Hospital | 175 N Medical Dr, Salt Lake City, UT 84132-0001 | 2011-06-09 |
| 1104075092 | Victoria Serpico | Special Hospital | 1950 Circle of Hope, Suite Number 6500, Salt Lake City, UT 84112 | 2008-09-16 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.