Organization
LIFE SKILLS VOCATIONAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEANIE PETTIT (OWNER)
(801) 254-2666
Entity
Organization
Contact information
Practice address
2656 W 1500 S, SALT LAKE CITY, UT 84104-4151
(801) 977-3732
Mailing address
15173 ROSE CANYON RD, HERRIMAN, UT 84065-4482
(801) 254-2666
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
04/04/2006
Last updated
08/22/2020
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