Provider Demographics
NPI:1093226771
Name:WAKE UP SENSE LLC
Entity Type:Organization
Organization Name:WAKE UP SENSE LLC
Other - Org Name:WAKE UP SENSE HOLISTIC HEALING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO-FOUNDER
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:A
Authorized Official - Last Name:LIFER
Authorized Official - Suffix:
Authorized Official - Credentials:CEO-FOUNDER
Authorized Official - Phone:801-564-1167
Mailing Address - Street 1:PO BOX 961
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84402-0961
Mailing Address - Country:US
Mailing Address - Phone:801-564-1167
Mailing Address - Fax:
Practice Address - Street 1:2454 MONROE BLVD
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84401-2506
Practice Address - Country:US
Practice Address - Phone:801-564-1167
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-20
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NAOtherNA