Life-Line, Inc.
NPI #1174711873 in North Salt Lake, Utah
Provider Information
- NPI Number
- 1174711873
- Entity Type
- Organization
- Organization Name
- Life-Line, Inc.
- Primary Specialty
- Clinic/Center - Rehabilitation, Substance Use Disorder
- Enumeration Date
- Oct 9, 2007
- Last Updated
- Oct 21, 2011
Practice Location
- Address
- 1130 W CENTER ST
- City
- North Salt Lake
- State
- Utah
- ZIP Code
- 84054-2917
- Phone
- (801) 936-4000
Authorized Official
- Name
- MR. SHANE R PETERSEN, MBA
- Title
- CHIEF EXECUTIVE OFFICER
- Phone
- (801) 936-4000
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Adolescent and Children Mental Health — Adolescent and Children Mental Health |
| Clinic/Center - Rehabilitation, Substance Use Disorder — Rehabilitation, Substance Use Disorder |
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