# BETWEEN THE LINES REJUVENATION LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396507984
- **Authorized official:** KRISTA CORBETT NP (OWNER)
- **Authorized official phone:** (801) 694-1197

## Contact information

- **Practice address:** 1785 E WILSON AVE, SALT LAKE CITY, UT 84108-2916
- **Practice address phone:** (877) 258-6331
- **Practice address fax:** (718) 362-1651
- **Mailing address:** 612 CORPORATE WAY STE 2M, VALLEY COTTAGE, NY 10989-2027
- **Mailing address phone:** (718) 362-1411
- **Mailing address fax:** (718) 362-1651

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | — |

## Other

- **Enumeration date:** 01/29/2024
- **Last updated:** 07/17/2024