Life Enhancement Center

NPI #1083876734 in Provo, Utah

Provider Information

NPI Number
1083876734
Entity Type
Organization
Organization Name
Life Enhancement Center
Primary Specialty
Community/Behavioral Health
Enumeration Date
Jun 25, 2008
Last Updated
Jun 25, 2008

Practice Location

Address
1835 N 1120 W
City
Provo
State
Utah
ZIP Code
84604-1180
Phone
(801) 623-4770

Authorized Official

Name
DR. RUSSELL C GAEDE, PSYD
Title
EXECUTIVE DIRECTOR
Phone
(801) 623-4770

Specialties & Taxonomy Codes

Specialty
Community/Behavioral Health

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