LIFE STONE GROUP, LLC (NPI# 1871829283) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871829283 |
| Entity Type | Organization |
| Organization Name | LIFE STONE GROUP, LLC |
| Practice Address |
613 E Fort Union Blvd Ste 104 Midvale UT 84047 |
| Mailing Address |
613 E Fort Union Blvd Ste 104 Midvale UT 84047-5531 |
| Practice Telephone | 8019841717 |
| Practice Fax Number | 8019841720 |
| Mailing Telephone | 8019841717 |
| Mailing Fax Number | 8019841720 |
| Enumeration Date | 2009-10-20 |
| Last Update Date | 2019-04-16 |
| Authorized Official Name | MRS. JULIE A. PETTIT (OWNER/PARTNER) |
| Authorized Official Telephone | 8019841717 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
15893 | UT | Ambulatory Health Care Facilities |
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 150 S 400 E, American Fork, UT 840032510 | 8019807222 | 8019807223 |
| Street Address |
613 E FORT UNION BLVD STE 104 |
| City | MIDVALE |
| State | UT |
| Zip Code | 84047 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063686160 | Wayne Sears | Counselor | 613 E Fort Union Blvd Ste 104, Midvale, UT 84047-5531 | 2008-04-18 |
| 1710539044 | Paige Nicole Gutzman | Counselor | 613 E Fort Union Blvd Ste 104, Midvale, UT 84047-5531 | 2019-07-16 |
| 1649733205 | Danette Lee Larsen | Counselor | 613 E Fort Union Blvd Ste 104, Midvale, UT 84047-5531 | 2019-04-10 |
| 1407360951 | Lacey Ann Hancock | Counselor | 613 E Fort Union Blvd Ste 104, Midvale, UT 84047 | 2017-11-20 |
| 1528578440 | Lisa Sovinsky | Counselor | 613 E Fort Union Blvd Ste 104, Midvale, UT 84047-5531 | 2017-10-05 |
| 1164802773 | Triona Mcmaster | Social Worker | 613 E Fort Union Blvd Ste 104, Midvale, UT 84047-5531 | 2015-06-09 |
| 1417263138 | Anastasia Eleftheria Doulis | Counselor | 613 E Fort Union Blvd Ste 104, Midvale, UT 84047-5531 | 2010-08-19 |
| 1316272354 | Amy Gillespie | Social Worker | 613 E Fort Union Blvd Ste 104, Midvale, UT 84047-5531 | 2009-10-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649885096 | Wound Pros Utah | Durable Medical Equipment & Medical Supplies | 6975 Union Park Avenue, Suite 600, Cottonwood Heights, UT 84047 | 2020-09-12 |
| 1457965824 | Duy Danny Vo | Pharmacist | 7200 S State St, Midvale, UT 84047 | 2020-09-03 |
| 1619457314 | Tlcpo LLC | Counselor | 6975 Union Park Avenue Suite 600, Cottonwood Heights, UT 84047 | 2018-08-21 |
| 1700371606 | Heather Ivana Lawrence | Social Worker | 6856 700 E, Midvale, Ut 84047, Midvale,ut, UT 84047 | 2018-06-25 |
| 1285128942 | A&a Counseling | Counselor | 7602 S Main St, Midvale, UT 84047 | 2018-06-17 |
| 1396235339 | Hhalmid | Assisted Living Facility | 6968 S 700 E, Midvale, UT 84047 | 2018-05-15 |
| 1750879987 | Rosemarie Elaine Brinig | Counselor | 75 E. Ft. Union, C118, Midvale, UT 84047 | 2018-04-24 |
| 1861921140 | Olivia Devenport | Behavior Technician | 7434 S State Street, Midvale, UT 84047 | 2017-06-08 |
| 1376083071 | Marathon Health, LLC | Nurse Practitioner | 7259 South Bingham Junction, C/o Chg- Ut Health Center, Midvale, UT 84047 | 2017-02-28 |
| 1710436316 | Michael Naanes | Physical Therapist | 900 East 6900 South, Suite 100, Midvale, UT 84047 | 2016-09-25 |
| Find all providers in zip 84047 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891810867 | Ihc Health Services Inc | Clinic/Center | 1225 Fort Union Blvd, Suite 215, Midvale, UT 84047-1889 | 2007-03-20 |
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| 1811548589 | Insaneability | Clinic/Center | 2013 E Fielding Hill Ln, Draper, UT 84020-2505 | 2019-09-24 |
| 1083264907 | Hobble Creek Behavoral Health | Clinic/Center | 1291 Expressway Ln # L, Spanish Fork, UT 84660-1333 | 2019-09-12 |
| 1407403983 | Haven Recovery LLC | Clinic/Center | 1474 W 2100 N, Pleasant Grove, UT 84062-9508 | 2019-08-20 |
| 1386299287 | Intermountain Counseling Center | Clinic/Center | 35 N Main Street, Suite 200 B, Spring City, UT 84662 | 2019-08-07 |
| 1710532619 | Solstone, LLC | Clinic/Center | 1353 N 1075 W Ste 204, Farmington, UT 84025-2772 | 2019-08-07 |
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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.