OrganizationActive
Cirque Lodge Inc.
NPI 1912108242 · Substance Abuse Rehabilitation Facility · Orem, UT
Provider details
- NPI number
- 1912108242
- Entity type
- Organization
- Primary specialty
- Substance Abuse Rehabilitation FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Gary Fisher, Director of Operations(801) 222-9200
- License
- 12370 (UT)
Specialties & taxonomies
Residential Treatment Facilities
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
777 N Palisades Dr
Orem, UT 84097-4341
Phone: (801) 222-9200
Fax: (801) 222-0112
Street-level locationGet directions
Mailing address
777 N Palisades Dr
Orem, UT 84097-4341
Registry dates
- Enumerated
- 2007-05-31
- Last updated
- 2016-11-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.