Organization
LIV WELL UTAH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL GONZALEZ (CHIEF EXECUTIVE OFFICER)
(480) 522-4268
Entity
Organization
Contact information
Practice address
21608 S 225TH WAY, QUEEN CREEK, AZ 85142-2855
(480) 522-4268
Mailing address
21608 S 225TH WAY, QUEEN CREEK, AZ 85142-2855
(480) 522-4268
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
09/22/2025
Last updated
10/16/2025
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