Organization
LIFE RENEWAL THERAPY
Active
Other names
Innovo
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID THOMPSON LMFT (OWNER/CLINICAL DIRECTOR)
(801) 319-2041
Entity
Organization
Contact information
Practice address
526 W CENTER ST STE N104, PLEASANT GROVE, UT 84062-3360
(801) 436-6747
Mailing address
146 N 765 E, PLEASANT GROVE, UT 84062-2879
(801) 319-2041
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
06/24/2025
Last updated
06/24/2025
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