LIFE LAUNCH CENTERS OF SOUTH SALT LAKE (NPI# 1336705292) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336705292 |
| Entity Type | Organization |
| Organization Name | LIFE LAUNCH CENTERS OF SOUTH SALT LAKE |
| Other Organization Name | LIFE LAUNCH CENTERS OF SOUTH SALT LAKE |
| Practice Address |
9289 S Redwood Rd Ste C West Jordan UT 84088-6731 |
| Mailing Address |
315 W Hilton Dr Ste 3 St George UT 84770-2203 |
| Practice Telephone | 8338033883 |
| Practice Fax Number | 4357670278 |
| Mailing Telephone | 4357670552 |
| Mailing Fax Number | 4357670278 |
| Enumeration Date | 2019-05-16 |
| Last Update Date | 2019-09-03 |
| Authorized Official Name | JONI L DYCHES (OWNER/CFO) |
| Authorized Official Telephone | 8018038240 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Life Launch Centers of South Salt Lake | Doing Business As Name - Organization |
| Street Address |
9289 S REDWOOD RD STE C |
| City | WEST JORDAN |
| State | UT |
| Zip Code | 84088-6731 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881178655 | Sierra Burt | Physician Assistant | 3584 West 90000 South Suite 304, West Jordan, UT 84088 | 2018-09-18 |
| 1659861847 | Miller Anesthesia Consultants PC | Anesthesiology | Jvmc Dept. of Anesthesiology, 3580 W. 9000 S., West Jordan, UT 84088 | 2018-05-14 |
| 1821501495 | Cleo Stephanides Cheney | Dentist | 8846 South Redwood Rd., Suite N201, West Jordan, UT 84088 | 2017-11-06 |
| 1124546742 | Crystal Lynn Santos | Counselor | 4431 8200 S, West Jordan, UT 84088 | 2017-09-04 |
| 1154705960 | Heston Farnsworth | Dentist | 9217 South Redwood Road, Suite B, West Jordan, UT 84088 | 2015-07-13 |
| 1750778767 | Andrew Cantwell | Dentist | 3855 7800 South #150, West Jordan, UT 84088 | 2015-04-17 |
| 1962764282 | Steven Howard Reano | Specialist | 8789 S Redwood Road, Ste 100, West Jordan, UT 84088 | 2012-06-12 |
| 1528328846 | Orthodontic Payment Services, LLC | Dentist | 1231 W 9000 S #d, West Jordan, UT 84088 | 2012-05-21 |
| 1588932321 | Jessica Millard | Counselor | 9278 S 1700 W, West Jordan, UT 84088 | 2011-12-08 |
| 1346553062 | Barbara Rouse | Counselor | 9278 Redwood Rd, West Jordan, UT 84088 | 2010-07-22 |
| Find all providers in zip 84088 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528541844 | Brittany Reva Bowen | Counselor | 7272 S 2530 W # Wet, West Jordan, UT 84084-3058 | 2018-09-12 |
| 1124546742 | Crystal Lynn Santos | Counselor | 4431 8200 S, West Jordan, UT 84088 | 2017-09-04 |
| 1386182483 | James Essex | Counselor | 8565 S 4770 W, West Jordan, UT 84088-4797 | 2017-02-08 |
| 1831548973 | Sarah Elizabeth Clark | Counselor | 7601 S Redwood Rd Ste E, West Jordan, UT 84084-4007 | 2016-06-09 |
| 1881080240 | Jeffrey Arbez Zinger | Counselor | 8235 S Spratling Dr, West Jordan, UT 84081-1733 | 2015-04-13 |
| 1225447774 | Denise Larouche | Counselor | 3864 W Garonne Ave, West Jordan, UT 84084-1927 | 2014-08-08 |
| 1356767388 | Ken C Mccauley | Counselor | 5454 Balsa Avenue, West Jordan, UT 84081 | 2014-03-14 |
| 1215367164 | Summer Luke | Counselor | 5500 W Bagley Park Rd Bldg J, West Jordan, UT 84081-5697 | 2013-11-13 |
| 1588932321 | Jessica Millard | Counselor | 9278 S 1700 W, West Jordan, UT 84088 | 2011-12-08 |
| 1346553062 | Barbara Rouse | Counselor | 9278 Redwood Rd, West Jordan, UT 84088 | 2010-07-22 |
| Find all providers in WEST JORDAN | ||||
| City | WEST JORDAN |
| Zip Code | 84088 |
Please comment or provide details below to improve the information on LIFE LAUNCH CENTERS OF SOUTH SALT LAKE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.