Life Elevated Psychiatry LLC

NPI #1063199305 in Draper, Utah

Provider Information

NPI Number: 1063199305
Entity Type: Organization
Organization Name: Life Elevated Psychiatry LLC
Primary Specialty: Clinic/Center - Mental Health (Including Community Mental Health Center)
Enumeration Date: Jun 29, 2023
Last Updated: Jun 29, 2023

Practice Location

Address: 11620 S STATE ST STE 1403
City: Draper
State: Utah
ZIP Code: 84020-7124
Phone: (385) 302-7369

Authorized Official

Name: BROCK HASKELL, PA-C
Title: OWNER
Phone: (385) 302-7369

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X	Primary

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