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Curtis Bryant Blackham
Substance Abuse Rehabilitation Facility in Moroni, Utah
NPI 1235425109

Curtis Bryant Blackham is a Substance Abuse Rehabilitation Facility based in Moroni, UT. Curtis Bryant Blackham practices in Moroni, UT. The NPI Number for Curtis Bryant Blackham is 1235425109 and holds a License No. 272503815 (Utah).

The current practice location address for Curtis Bryant Blackham is 21260 N 1450 E, Moroni, UT and can be reached out via phone at 435-445-5200 and via fax at 435-445-5201.

Location: 21260 N 1450 E, Moroni, UT, 84646-0461
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1235425109
Provider Name
Curtis Bryant Blackham
Credential
Provider Entity Type
Individual
Gender
Male
Address
21260 N 1450 E, Moroni, UT, 84646-0461
Phone Number
435-445-5200
Fax Number
435-445-5201
Provider Enumeration Date
06/20/2011
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
21260 N 1450 E
City
Moroni
State
Utah
Zip
84646-0461
Phone Number
435-445-5200
Fax Number
435-445-5201
person
Provider Business Mailing Address Details
Address
21260 N 1450 E
City
Moroni
State
Utah
Zip
84646-0461
Phone Number
435-445-5200
Fax Number
435-445-5201
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Substance Abuse Rehabilitation Facility
Speciality
-
Taxonomy
324500000X
License No.
272503815 (Utah)
Definition
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.
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