Provider Demographics
NPI:1215269949
Name:PASSAGES TO RECOVERY
Entity type:Organization
Organization Name:PASSAGES TO RECOVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GILBERT
Authorized Official - Middle Name:D
Authorized Official - Last Name:HALLOWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-836-2472
Mailing Address - Street 1:PO BOX 379
Mailing Address - Street 2:
Mailing Address - City:LOA
Mailing Address - State:UT
Mailing Address - Zip Code:84747-0379
Mailing Address - Country:US
Mailing Address - Phone:435-836-1400
Mailing Address - Fax:435-836-2258
Practice Address - Street 1:98 SOUTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:LOA
Practice Address - State:UT
Practice Address - Zip Code:84747
Practice Address - Country:US
Practice Address - Phone:435-836-1400
Practice Address - Fax:435-836-2258
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CRC HEALTH CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-02-05
Last Update Date:2010-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility