Life-Line, Inc.
NPI #1699943118 in North Salt Lake, Utah
Provider Information
- NPI Number
- 1699943118
- Entity Type
- Organization
- Organization Name
- Life-Line, Inc.
- Primary Specialty
- Substance Abuse Rehabilitation Facility
- Enumeration Date
- Feb 19, 2008
- 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 |
|---|
| Substance Abuse Rehabilitation Facility |
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