LIFE ENHANCEMENT CENTER (NPI# 1326304023) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326304023 |
| Entity Type | Organization |
| Organization Name | LIFE ENHANCEMENT CENTER |
| Practice Address |
1835 N 1120 W Provo UT 84604-1180 |
| Practice Telephone | 8016234770 |
| Practice Fax Number | 8016234771 |
| Mailing Telephone | 8016234770 |
| Mailing Fax Number | 8016234771 |
| Enumeration Date | 2012-04-06 |
| Last Update Date | 2012-06-25 |
| Authorized Official Name | MRS. SHELLEY MANGUM (ASS. CLINICAL MENTAL HEALTH COUNSEL) |
| Authorized Official Telephone | 8017960620 |
| Authorized Official Credential | ACMHC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
5828209-6009 | UT | Ambulatory Health Care Facilities |
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
5828209-6009 | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740428705 | Life Enhancement Center | Community/Behavioral Health | 3595 University Ave Suite E, Riverside, CA 92501 | 2009-01-29 |
| 1083876734 | Life Enhancement Center | Community/Behavioral Health | 1835 N 1120 W, Provo, UT 84604-1180 | 2008-06-25 |
| Street Address |
1835 N 1120 W |
| City | PROVO |
| State | UT |
| Zip Code | 84604-1180 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821157355 | Jason H King | Counselor | 1835 N 1120 W, Provo, UT 84604-1180 | 2006-12-08 |
| 1194065664 | Ana Lia Borges De Martinez | Marriage & Family Therapist | 1835 N 1120 W, Provo, UT 84604-1180 | 2013-02-21 |
| 1598019366 | Luca Reid | Counselor | 1835 N 1120 W, Provo, UT 84604-1180 | 2012-11-01 |
| 1083970206 | Tiffany Roe | Counselor | 1835 N 1120 W, Provo, UT 84604-1180 | 2012-04-02 |
| 1578839742 | Laura Jacobsen Carter | Community/Behavioral Health | 1835 N 1120 W, Provo, UT 84604-1180 | 2012-03-31 |
| 1508140989 | David E Ward Jr. | Counselor | 1835 N 1120 W, Provo, UT 84604-1180 | 2011-10-04 |
| 1023326956 | Allison Hansen | Counselor | 1835 N 1120 W, Provo, UT 84604-1180 | 2010-09-14 |
| 1538475843 | Tracie Dana Foster | Counselor | 1835 N 1120 W, Provo, UT 84604-1180 | 2010-08-24 |
| 1083876734 | Life Enhancement Center | Community/Behavioral Health | 1835 N 1120 W, Provo, UT 84604-1180 | 2008-06-25 |
| 1225197759 | Russell Clifford Gaede | Counselor | 1835 N 1120 W, Provo, UT 84604-1180 | 2006-12-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346882107 | Abigail Belle Hardy | Student in an Organized Health Care Education/Training Program | 1190 900 E, Provo, UT 84604 | 2019-10-14 |
| 1386106698 | Sarah Roseman Hunt | Nurse Practitioner | 1055 N 500 W., Suite. 101, Bldg. C, Provo, UT 84604 | 2019-04-04 |
| 1255813325 | Hwigeum Jeong | Specialist/Technologist | Department of Exercise Sciences 106 Sfh Brigham Young, Provo, UT 84604 | 2018-09-05 |
| 1093203044 | Snowcap Smile Studio LLC | Dentist | 2230 N. University Pkwy Ste 8b, Provo, UT 84604 | 2018-04-25 |
| 1407359078 | Ihc Health Services Inc | Clinic/Center | 380 W Bulldog Blvd, Ste 403, Provo, UT 84604 | 2018-03-09 |
| 1902308455 | Afton Leuga | Nurse Practitioner | 395 W Bulldog Blvd., Suite 401, Provo, UT 84604 | 2018-03-01 |
| 1851807333 | Ihc Health Services Inc | Family Medicine | 380 W 1230 N, Ste 602, Provo, UT 84604 | 2017-12-20 |
| 1689180218 | Ihc Health Services Inc | Pediatrics | 395 W Bulldog Blvd Ste 703, Provo, UT 84604 | 2017-12-19 |
| 1396254165 | Nicolas Sorensen | Massage Therapist | 247 West 2230 North #201, Provo, UT 84604 | 2017-09-25 |
| 1437692241 | Cirque Lodge Inc | Substance Abuse Rehabilitation Facility | 3114 E Ida's Road, Sundance, UT 84604 | 2016-11-28 |
| Find all providers in zip 84604 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942690656 | Hughes Therapy 1 | Clinic/Center | 3585 N University Ave Ste 350, Provo, UT 84604-6608 | 2015-02-02 |
| 1790306652 | Pinnacle Addiction Ave. & Mental Health Therapy | Clinic/Center | 3507 N University Ave, Provo, UT 84604-4478 | 2020-05-01 |
| 1447625611 | Connections Counseling Services | Clinic/Center | 667 N 1890 W, Provo, UT 84601 | 2015-12-14 |
| 1063833721 | Life Integrative Health Center | Clinic/Center | 777 N 500 W, Suite 104, Provo, UT 84601-1541 | 2013-12-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649819020 | Topaz Counseling Pllc | Clinic/Center | 520 Topaz Blvd Ste 203d, Delta, UT 84624-4103 | 2020-01-02 |
| 1992346704 | Anicka Inc | Clinic/Center | 3195 South Main St, Ste 260, South Salt Lake, UT 84115 | 2019-10-02 |
| 1871145227 | Pinyon Pine Counseling | Clinic/Center | 1240 E 100 S Bldg 23, Saint George, UT 84790-3001 | 2019-07-15 |
| 1225590755 | Amy Henderson Lcsw LLC | Clinic/Center | 4055 S 700 E Ste 102a, Salt Lake City, UT 84107-2174 | 2019-04-03 |
| 1205314747 | North Star Counseling Services | Clinic/Center | 298 24th St Ste 204, Ogden, UT 84401-1870 | 2018-08-06 |
| 1194223867 | Cottonwood Behavioral Counseling LLC | Clinic/Center | 6337 S Highland Dr # 227 Suite 227, Salt Lake City, UT 84121-8558 | 2018-01-29 |
| 1174021281 | Insight Recovery Cedar City LLC | Clinic/Center | 535 S Main St Ste 2, Cedar City, UT 84720-3576 | 2018-01-24 |
| 1265941702 | Silver Creek Psychiatry | Clinic/Center | 1480 E 820 N, Orem, UT 84097-5481 | 2017-09-27 |
| 1336533348 | Salt Lake Weight Counseling | Clinic/Center | 7105 S. Highland Dr. Ste 202, Salt Lake City, UT 84121 | 2015-03-27 |
| 1174924310 | At The Crossroads | Clinic/Center | 139 North 100 West, St. George, UT 84770 | 2014-09-08 |
| Find all providers with the same taxonomy | ||||
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| 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.