MARVON SHANE HOLDAWAY CM
NPI 1053045898
Clinic/Center - Rehabilitation, Substance Use Disorder in Mount Pleasant, UT

Q: What is the provider's specialty?

The provider's specialty is Clinic/Center with taxonomy code 261QR0405X and a focus in Rehabilitation, Substance Use Disorder.

Active since July 15, 2022

265 N STATE ST, MOUNT PLEASANT, UT 84647(435) 462-2781(435) 462-0155 Get Directions Write a Review

NPPES record last updated: July 18, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 18, 2022, Jul 15, 2022 (2 updates tracked since 2022).

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About Marvon Shane Holdaway Cm NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARVON SHANE HOLDAWAY CM (NPI 1053045898) is an individual rehabilitation, substance use disorder provider in Mount Pleasant, Utah and active in the NPI registry since July 2022.

NPPES Registry Identity

NPI1053045898

Entity TypeIndividualMale

Primary Taxonomy261QR0405X

Provider Legal NameMARVON SHANE HOLDAWAYCredential: CM

Location Address265 N STATE STMount Pleasant, UT 84647-1108

Mailing AddressPo Box 31Mt Pleasant, UT 84647-0031 · (435) 462-2781 · Fax (435) 462-0155

Phone(435) 462-2781

Fax(435) 462-0155

Sole ProprietorYes

Enumeration DateJuly 15, 2022

Last NPPES UpdateJuly 18, 20222 updates tracked since enumeration

NPPES CertifiedJuly 18, 2022

✔ NPI 1053045898 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rehabilitation, Substance Use DisorderAmbulatory Health Care Facilities

Taxonomy Code261QR0405X

265 N STATE ST, Mount Pleasant, UT 84647

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Other Identifiers 1

MedicaidHT007021-001UT

Other Providers at the Same Location NPPES 19

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MATR, INC.

Substance Abuse Rehabilitation Facility