Lifeline Behavioral Health, LLC
NPI #1780884742 in North Salt Lake, Utah
Provider Information
- NPI Number
- 1780884742
- Entity Type
- Organization
- Organization Name
- Lifeline Behavioral Health, LLC
- Primary Specialty
- Substance Abuse Rehabilitation Facility - Substance Abuse Treatment, Children
- Enumeration Date
- Jul 18, 2007
- Last Updated
- Apr 10, 2015
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 |
|---|
| Psychiatric Residential Treatment Facility |
| Clinic/Center - Adolescent and Children Mental Health — Adolescent and Children Mental Health |
| Clinic/Center - Rehabilitation, Substance Use Disorder — Rehabilitation, Substance Use Disorder |
| Substance Abuse Rehabilitation Facility - Substance Abuse Treatment, Children — Substance Abuse Treatment, Children |
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