Lifestar Salt Lake, Llc | |
151 E 5600 S #204 Murray UT 84107-6181 | |
(801) 262-2400 | |
(801) 262-9991 |
Full Name | Lifestar Salt Lake, Llc |
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Speciality | Community/behavioral Health |
Location | 151 E 5600 S, Murray, Utah |
Authorized Official Name and Position | Daniel D Gray (CLINICAL DIRECTOR) |
Authorized Official Contact | 8012622400 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Lifestar Salt Lake, Llc 151 E 5600 S #204 Murray UT 84107-6181 Ph: (801) 262-2400 | Lifestar Salt Lake, Llc 151 E 5600 S #204 Murray UT 84107-6181 Ph: (801) 262-2400 |
NPI Number | 1528306446 |
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Provider Enumeration Date | 01/28/2013 |
Last Update Date | 01/28/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1528306446 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | 123039-3501 (Utah) | Primary |
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