Provider Demographics
NPI:1649724659
Name:UNA VIDA MEJOR LLC
Entity type:Organization
Organization Name:UNA VIDA MEJOR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:IVONNE
Authorized Official - Middle Name:JESSICA
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:801-879-8984
Mailing Address - Street 1:5685 S CORA WAY
Mailing Address - Street 2:
Mailing Address - City:TAYLORSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84129-2317
Mailing Address - Country:US
Mailing Address - Phone:801-879-8984
Mailing Address - Fax:
Practice Address - Street 1:175 S MAIN ST STE 500
Practice Address - Street 2:
Practice Address - City:SLC
Practice Address - State:UT
Practice Address - Zip Code:84111-1927
Practice Address - Country:US
Practice Address - Phone:801-890-4501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-08
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8639940-3501251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health