NPI 1083876734

Life Enhancement Center

Organisation Community/Behavioral Health Agency Provo, UT

Practice location

Address: 1835 N 1120 W, Provo, UT 84604-1180
Phone: (801) 623-4770
Fax: (801) 623-4771

Authorised official

Name: Russell C Gaede
Title: Executive Director
Phone: (801) 623-4770

Registered specialties

Community/Behavioral Health Agency Primary

Agencies Taxonomy 251S00000X Licence 6332186-0142 (UT)

Other Community/Behavioral Health providers in Utah →

Registry record

NPI: 1083876734
Entity type: Organization
NPI issued: 25 Jun 2008
Record last updated: 25 Jun 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.