RED CIRCLE LODGE INC NPI 1083107320

NPI Information

  • NPI: 1083107320
  • Provider Name: RED CIRCLE LODGE, INC
  • Classification: Substance Abuse Rehabilitation Facility - 3245S0500X
  • Specialization: Substance Abuse Treatment, Children
  • Entity Type: Organization
  • CLIA Number: 46D2159321
  • Address: 930 N MEMORIAL ST
    HILDALE, UT
    ZIP 84784
  • Phone: (435) 874-1467

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NPI Details

RED CIRCLE LODGE, INC is a substance abuse treatment and children substance abuse rehabilitation facility in Hildale, UT. The provider is a facility or distinct part of a facility for children that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included. RED CIRCLE LODGE, INC NPI is 1083107320. The provider is registered as an organization entity type.

The provider's business location address is:

930 N MEMORIAL ST
HILDALE, UT
ZIP 84784
Phone: (435) 874-1467

The provider's authorized official is Lane Shepherd .
The authorized official title is Clinical Director and has the following contact phone number (435) 229-9437.

The CLIA number assigned to this NPI record is 46D2159321 - other - residential treatment with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/12/2018 and was last updated on 6/12/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1322D00000XResidential Treatment Facility, Emotionally Disturbed ChildrenNo
23245S0500XSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, ChildrenYes

What is NPI?

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This page was last updated on: 11/21/2025

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