Life Stone Group, LLC

NPI #1871829283 in Midvale, Utah

Provider Information

NPI Number: 1871829283
Entity Type: Organization
Organization Name: Life Stone Group, LLC
Primary Specialty: Clinic/Center - Mental Health (Including Community Mental Health Center)
Enumeration Date: Oct 20, 2009
Last Updated: Apr 16, 2019

Practice Location

Address: 613 E FORT UNION BLVD STE 104
City: Midvale
State: Utah
ZIP Code: 84047
Phone: (801) 984-1717

Authorized Official

Name: MRS. JULIE A. PETTIT
Title: OWNER/PARTNER
Phone: (801) 984-1717

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Rehabilitation, Substance Use Disorder — Rehabilitation, Substance Use Disorder	261QR0405X
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X	Primary

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