Life Integrative Health Center

NPI #1063833721 in Provo, Utah

Provider Information

NPI Number: 1063833721
Entity Type: Organization
Organization Name: Life Integrative Health Center
Primary Specialty: Clinic/Center
Enumeration Date: Dec 26, 2013
Last Updated: Apr 9, 2014

Practice Location

Address: 777 N 500 W
Address 2: SUITE 104
City: Provo
State: Utah
ZIP Code: 84601-1541
Phone: (801) 869-8199

Authorized Official

Name: MRS. KENDRA BERNAL, MA
Title: CLINICAL ADMINISTRATOR
Phone: (801) 869-8199

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Adult Mental Health — Adult Mental Health	261QM0850X
Clinic/Center - Health Service — Health Service	261QH0100X
Clinic/Center - Adolescent and Children Mental Health — Adolescent and Children Mental Health	261QM0855X
Clinic/Center	261Q00000X	Primary

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