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PURE LIFE PTG NPI 1003323767


NPI Information

NPI: 1003323767
Provider Name: PURE LIFE PTG
Classification: Psychologist - 103TA0400X
Entity Type: Organization

Specialization: Addiction (Substance Use Disorder)

Address:
7390 S CREEK RD STE 202
SANDY, UT
ZIP 84093
Phone: (801) 893-2550
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PURE LIFE PTG is an addiction (substance use disorder) psychologist in Sandy, UT. The provider is a psychologist with a proficiency that involves the application of psychological treatment of addiction stemming from the use of alcohol and other psychoactive substances (e.g., nicotine, marijuana, cocaine, heroin) or behavioral addictions (e.g., gambling) with the aim of cessation or reduction of use and/or the amelioration of emotional, behavioral, interpersonal and other problems arising from the addictive behavior. PURE LIFE PTG NPI is 1003323767. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

7390 S CREEK RD STE 202
SANDY, UT
ZIP 84093-123
Phone: (801) 893-2550

The provider's authorized official is John Lund .
The authorized official title is Executive Director and has the following contact phone number (801) 664-3741.

The enumeration date for this NPI number is 1/3/2018 and was last updated on 1/3/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103TA0400XPsychologistAddiction (Substance Use Disorder)Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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