NPI: 1174711873
Provider Name: LIFE-LINE, INC.
Doing Business As: LIFELINE FOR YOUTH
Classification: Clinic/Center - 261QR0405X
Entity Type: Organization
Specialization: Rehabilitation, Substance Use Disorder
Address:
1130 W CENTER ST
NORTH SALT LAKE, UT
ZIP 84054
Phone: (801) 936-4000
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LIFE-LINE, INC. is a rehabilitation and substance use disorder clinic center in North Salt Lake, UT. LIFE-LINE, INC. NPI is 1174711873. The provider is registered as an organization entity type.
The provider Is Doing Business As Lifeline For Youth.
The provider's business location address is:
1130 W CENTER ST
NORTH SALT LAKE, UT
ZIP 84054-917
Phone: (801) 936-4000
The provider's authorized official is Shane R Petersen .
The authorized official title is Chief Executive Officer and has the following contact phone number (801) 936-4000.
The enumeration date for this NPI number is 10/9/2007 and was last updated on 10/21/2011.