Life Enhancement Center

NPI #1326304023 in Provo, Utah

Provider Information

NPI Number: 1326304023
Entity Type: Organization
Organization Name: Life Enhancement Center
Primary Specialty: Clinic/Center - Adult Mental Health
Enumeration Date: Apr 6, 2012
Last Updated: Jun 25, 2012

Practice Location

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

Authorized Official

Name: MRS. SHELLEY MANGUM, ACMHC
Title: ASS. CLINICAL MENTAL HEALTH COUNSEL
Phone: (801) 796-0620

Specialties & Taxonomy Codes

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

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