Provider Demographics
NPI:1407515760
Name:LIFE LAUNCH CENTERS, LLC
Entity Type:Organization
Organization Name:LIFE LAUNCH CENTERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL DIR
Authorized Official - Prefix:
Authorized Official - First Name:JONI
Authorized Official - Middle Name:
Authorized Official - Last Name:DYCHES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-803-8240
Mailing Address - Street 1:230 N 1680 E STE J1
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-2588
Mailing Address - Country:US
Mailing Address - Phone:435-767-0552
Mailing Address - Fax:435-767-0278
Practice Address - Street 1:230 N 1680 E STE J1
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-2588
Practice Address - Country:US
Practice Address - Phone:435-767-0552
Practice Address - Fax:435-767-0278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-14
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty