Provider Demographics
NPI:1912893843
Name:NEW LEAF MENTAL WELLNESS LLC
Entity type:Organization
Organization Name:NEW LEAF MENTAL WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PART OWNER / ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:HAYLEE
Authorized Official - Middle Name:
Authorized Official - Last Name:WEBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:385-427-4721
Mailing Address - Street 1:1246 E 530 N
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84097-5439
Mailing Address - Country:US
Mailing Address - Phone:801-836-7806
Mailing Address - Fax:
Practice Address - Street 1:802 E BAMBERGER DR STE A
Practice Address - Street 2:
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-2179
Practice Address - Country:US
Practice Address - Phone:385-427-4721
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health