Organization
PURE LIFE ASPIRO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW TAYLOR (EXECUTIVE DIRECTOR)
(801) 232-5568
Entity
Organization
Contact information
Practice address
63 E 11400 S, 186, SANDY, UT 84070-6705
(801) 349-2740
Mailing address
APARTADO 775-8000, SAN JOSE, PEREZ ZELEDON, SAN ISIDRO 11901
(801) 232-5568
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
06/19/2014
Last updated
06/19/2014
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