REBOOT CENTERS HOBBLE CREEK (NPI# 1780215269) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780215269 |
| Entity Type | Organization |
| Organization Name | REBOOT CENTERS HOBBLE CREEK |
| Practice Address |
1154 Left Fork Hobble Creek Canyon Rd Springville UT 84663 |
| Practice Telephone | 9294374325 |
| Mailing Telephone | 9294374325 |
| Enumeration Date | 2020-02-03 |
| Last Update Date | 2020-02-03 |
| Authorized Official Name | DR. WENDEL SMITH (PRESIDENT) |
| Authorized Official Telephone | 8013760577 |
| Authorized Official Credential | LMT, PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103G00000X | Clinical Neuropsychologist | Behavioral Health & Social Service Providers | ||
| N | 103K00000X | Behavioral Analyst | Behavioral Health & Social Service Providers | ||
| N | 106H00000X | Marriage & Family Therapist | Behavioral Health & Social Service Providers | ||
| N | 111NN0400X |
Chiropractor Specialization: Neurology |
Chiropractic Providers | ||
| N | 133NN1002X |
Nutritionist Specialization: Nutrition, Education |
Dietary & Nutritional Service Providers | ||
| N | 146N00000X | Emergency Medical Technician, Basic | Emergency Medical Service Providers | ||
| N | 152WV0400X |
Optometrist Specialization: Vision Therapy |
Eye and Vision Services Providers | ||
| N | 171100000X | Acupuncturist | Other Service Providers | ||
| N | 173C00000X | Reflexologist | Other Service Providers | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 221700000X | Art Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 225700000X | Massage Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 225A00000X | Music Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 246RP1900X |
Technician, Pathology Specialization: Phlebotomy |
Technologists, Technicians & Other Technical Service Providers | ||
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| Street Address |
1154 LEFT FORK HOBBLE CREEK CANYON RD |
| City | SPRINGVILLE |
| State | UT |
| Zip Code | 84663 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659900835 | Change Academy At Lake of The Ozarks | Residential Treatment Facility, Emotionally Disturbed Children | 266 South Left Fork Hobble Creek Canyon Road, Springville, UT 84663 | 2020-04-08 |
| 1063053866 | Jesus Lopez | Clinic/Center | 1461 Archmore Loop, Springville, UT 84663 | 2019-10-02 |
| 1689109506 | Cd Pharmacy LLC | Pharmacy | 863 W 450 S, Suite 201, Springville, UT 84663 | 2017-04-28 |
| 1215479225 | Jaydynn Cusworth | Behavior Technician | 692 S 2800 W Unit I 101, Springville, UT 84663 | 2016-11-08 |
| 1245699602 | Pamela Jamison | Speech-Language Pathologist | 1072 Wildflower Way, Springville, UT 84663 | 2016-02-14 |
| 1013397348 | Lindsay Erickson | Counselor | 470 Buckley Ave, Springville, UT 84663 | 2015-06-02 |
| 1790084903 | Grant Lee Murdoch | Counselor | 1102 N 850 W, Springville, UT 84663 | 2011-03-28 |
| 1306148739 | Siuta Sonny Faaootoa | Counselor | 551 North Main Street, Springville, UT 84663 | 2010-11-17 |
| 1891000790 | Christopher David Westover | Social Worker | 716 N 200 E, Springville, UT 84663 | 2010-08-16 |
| 1104142983 | Renn Garrett Flinders | Dentist | 1795 W 500 S Ste B2, Springville, UT 84663 | 2010-04-19 |
| Find all providers in zip 84663 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255943569 | Skull Valley Health Care | Clinic/Center | 1929 N Aaron Dr, Tooele, UT 84074-8112 | 2020-08-18 |
| 1003427923 | Painted Desert Recovery LLC | Clinic/Center | 1947 S 2800 E, New Harmony, UT 84757-5115 | 2020-08-13 |
| 1437780673 | Beecon Recovery | Clinic/Center | 60 S Main St Ste B0001, Brigham City, UT 84302-6795 | 2020-01-27 |
| 1124666870 | One Voice Recovery | Clinic/Center | 1400 S 1100 E, Salt Lake City, UT 84105-2435 | 2019-12-12 |
| 1992343834 | Avante Recovery Center, LLC | Clinic/Center | 848 E 1475 N, Lehi, UT 84043-3568 | 2019-12-11 |
| 1467912139 | Infinite Arches LLC | Clinic/Center | 136 25th St, Ogden, UT 84401-1302 | 2019-03-20 |
| 1669952958 | Utah Harm Reduction Coalition | Clinic/Center | 91 E 7200 S, Midvale, UT 84047-1531 | 2018-08-16 |
| 1871016840 | Breakaway Recovery Center Murray, LLC | Clinic/Center | 5296 S Commerce Dr Ste 204, Murray, UT 84107-5393 | 2017-07-21 |
| 1528580180 | Brighton House LLC | Clinic/Center | 2945 E Robidoux Rd, Sandy, UT 84093-1128 | 2017-07-14 |
| 1316392897 | Nuway Recovery, LLC | Clinic/Center | 4925 S 900 E, Salt Lake City, UT 84117-5784 | 2016-05-03 |
| Find all providers with the same taxonomy | ||||
| City | SPRINGVILLE |
| Zip Code | 84663 |
Please comment or provide details below to improve the information on REBOOT CENTERS HOBBLE CREEK.
| 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.