LIFE STONE GROUP LLC NPI 1871829283

NPI Information

NPI: 1871829283
Provider Name: LIFE STONE GROUP, LLC
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
613 E FORT UNION BLVD STE 104
MIDVALE, UT
ZIP 84047
Phone: (801) 984-1717
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LIFE STONE GROUP, LLC is a mental health (including community mental health center) clinic center in Midvale, UT. LIFE STONE GROUP, LLC NPI is 1871829283. The provider is registered as an organization entity type.

The provider's business location address is:

613 E FORT UNION BLVD STE 104
MIDVALE, UT
ZIP 84047
Phone: (801) 984-1717
Fax: (801) 984-1720

The provider's authorized official is Julie A. Pettit .
The authorized official title is Owner/partner and has the following contact phone number (801) 984-1717.

The enumeration date for this NPI number is 10/20/2009 and was last updated on 4/16/2019.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder	15893	UTAH	No
2	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)			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: 11/14/2023

NPI Synchronization or Removal

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