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Moonlight Mountain Recovery, Inc

Substance Abuse Rehabilitation Facility in Pocatello, ID · enumerated 2018 · authorized official Wade Morden, Owner.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1861983413

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Registry record

Entity type Organization (Type 2)
Legal business name Moonlight Mountain Recovery, Inc
Practice address 5230 W Moonlight Mine Rd, Pocatello, ID, 83201
Phone (208) 505-9990
Enumeration date May 18, 2018
Last updated in NPPES Jan 13, 2021

Taxonomy & classification

261QM0801X Mental Health Clinic/Center (Including Community Mental Health Center) Ambulatory Health Care Facilities Secondary
261QM0850X Adult Mental Health Clinic/Center Ambulatory Health Care Facilities Secondary
261QR0405X Substance Use Disorder Rehabilitation Clinic/Center Ambulatory Health Care Facilities Secondary
324500000X Substance Abuse Rehabilitation Facility Residential Treatment Facilities · License 1 (ID) Primary

Authorized official

Name Wade Morden
Title Owner
Phone (208) 505-9990

Other identifiers

Identifier Type State Issuer
1 Other ID CERTIFICATE OF APPROVAL

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2021-01-13. Verify at npiregistry.cms.hhs.gov.
Where is Moonlight Mountain Recovery, Inc located?
The practice location on file with NPPES is in Pocatello, ID.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2021-01-13.