RED CIRCLE LODGE, INC — NPI 1083107320 (Licensed & Credentialed Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children in HILDALE, UT)

CMS-1500 Box 24J / 33a • NPI

1083107320

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

3245S0500X

Licensed & Credentialed Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children

Box 32 Service Location & ZIP+4

930 N MEMORIAL ST, HILDALE, UT, 84784

Official NPPES Practice Location

Practice Phone & Referral Fax

(435) 874-1467

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1083107320 (RED CIRCLE LODGE, INC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1083107320` (NPI-2 Organization / Facility)
Provider / Legal Name	RED CIRCLE LODGE, INC
Plain-English Specialty	Licensed & Credentialed Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children NUCC Code: `3245S0500X` (Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	930 N MEMORIAL ST, HILDALE, UT, 84784
Practice Telephone / Fax	Tel: (435) 874-1467
Administrative Mailing Address	930 N MEMORIAL ST #1670, HILDALE, UT, 84784
Enumeration & Last Sync	Enumerated: 2018-06-12 \| CMS Record Updated: 2018-06-12
Authorized Official	LANE SHEPHERD (Clinical Director)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

930 N MEMORIAL ST, HILDALE, UT, 84784

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Plain-English Taxonomy & CMS Crosswalk (3245S0500X)

What Does Taxonomy Code 3245S0500X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 3245S0500X translates to:
"Licensed & Credentialed Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (RED CIRCLE LODGE, INC)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`322D00000X` — Residential Treatment Facility, Emotionally Disturbed Children Plain English: Licensed & Credentialed Residential Treatment Facility, Emotionally Disturbed Children	State: N/A \| License: `Verified` \| Primary: Secondary
`3245S0500X` — Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children Plain English: Licensed & Credentialed Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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RED CIRCLE LODGE, INC (NPI #1083107320)