Provider Demographics
NPI:1073152021
Name:IGNITING CHANGE LLC
Entity Type:Organization
Organization Name:IGNITING CHANGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:TORREY
Authorized Official - Middle Name:
Authorized Official - Last Name:HARMON
Authorized Official - Suffix:
Authorized Official - Credentials:CMHC
Authorized Official - Phone:801-376-3664
Mailing Address - Street 1:179 N 1200 E STE 101
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-2148
Mailing Address - Country:US
Mailing Address - Phone:801-806-4878
Mailing Address - Fax:877-695-7720
Practice Address - Street 1:179 N 1200 E STE 101
Practice Address - Street 2:
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-2148
Practice Address - Country:US
Practice Address - Phone:801-806-4878
Practice Address - Fax:877-695-7720
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-21
Last Update Date:2019-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)