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Ethan Colburn, CMHCI
Substance Abuse Rehabilitation Facility in Moroni, Utah
NPI 1316314081

Ethan Colburn is a Substance Abuse Rehabilitation Facility based in Moroni, UT. Ethan Colburn practices in Moroni, UT and has the professional credentials of CMHCI. The NPI Number for Ethan Colburn is 1316314081 and holds a License No. (Utah).

The current practice location address for Ethan Colburn is 21360 N 1450 E, Moroni, UT and can be reached out via phone at 435-445-5200 and via fax at 435-445-5201.

Location: 21360 N 1450 E, Moroni, UT, 84646-0461
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1316314081
Provider Name
Ethan Colburn
Credential
CMHCI
Provider Entity Type
Individual
Gender
Male
Address
21360 N 1450 E, Moroni, UT, 84646-0461
Phone Number
435-445-5200
Fax Number
435-445-5201
Provider Enumeration Date
08/28/2015
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
272503815 05 UT
institution
Provider Business Practice Location Address Details
Address
21360 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
21360 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.
(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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