Organization
LIFE ELEVATED FAMILY MEDICINE & COUNSELING LLC
Active
Organization
LIFE ELEVATED FAMILY MEDICINE & COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BROCK DAN HASKELL (PA/OWNER)
(435) 830-0554
Entity
Organization
Contact information
Practice address
3686 W. 2100 S., SALT LAKE CITY, UT 84120-8412
(435) 830-0554
(385) 247-8023
Mailing address
2561 S 1560 W STE B, WOODS CROSS, UT 84087-2361
(801) 505-0821
(801) 505-0803
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
118561179-1206
LICENSE
UT
Enumeration date
10/01/2021
Last updated
10/01/2021
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up