| NPI | 1174711873 |
|---|---|
| Doing Business As | LIFELINE FOR YOUTH |
| Entity Type | Organization |
| Authorized Contact | SHANE R PETERSEN Chief Executive Officer 801-936-4000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: UT 11832) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: UT 11832) |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2011-10-21 |