OrganizationActive
Legacy Outdoor Adventures LLC
NPI 1245509918 · Substance Abuse Rehabilitation Facility · Loa, UT
Provider details
- NPI number
- 1245509918
- Entity type
- Organization
- Primary specialty
- Substance Abuse Rehabilitation FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Gilbert Hallows, Executive Director(435) 836-2272
Specialties & taxonomies
Residential Treatment Facilities
Practice location
56 South Main Street
Loa, UT 84747
Phone: (435) 836-2272
Fax: (435) 836-2274
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 400
Loa, UT 84747-0400
Registry dates
- Enumerated
- 2011-12-23
- Last updated
- 2011-12-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.