| Emanate Light Nonprofit | |
|
33 N 100 E Apt B7 Moroni UT 84646-7659 | |
| (801) 400-0513 | |
| Not Available |
| Full Name | Emanate Light Nonprofit |
|---|---|
| Speciality | Behavior Analyst |
| Location | 33 N 100 E Apt B7, Moroni, Utah |
| Authorized Official Name and Position | Christopher A Stapleton (CHAIRMAN OF THE BOARD) |
| Authorized Official Contact | 8014000513 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Emanate Light Nonprofit Po Box 683 Moroni UT 84646-0683 Ph: (801) 400-0513 | Emanate Light Nonprofit 33 N 100 E Apt B7 Moroni UT 84646-7659 Ph: (801) 400-0513 |
| NPI Number | 1710858899 |
|---|---|
| Provider Enumeration Date | 09/13/2025 |
| Last Update Date | 09/13/2025 |
| Certification Date | 09/13/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710858899 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
Cold White Fire L3c Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 33 N 100 E Apt B7, Moroni, UT 84646 Phone: 801-400-0513 |