Organization
LLHC ST. GEORGE LLC
Active
Other names
Life Life Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RONALD DAVID TILLER P.A. (MEDICAL DIRECTOR)
(435) 574-9777
Entity
Organization
Contact information
Practice address
120 W 1470 S, ST GEORGE, UT 84770-6798
(435) 574-9777
Mailing address
120 W 1470 S, ST GEORGE, UT 84770-6798
(435) 574-9777
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
7300098-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1497716344
NPI
UT
01
—
1881630572
NPI
UT
01
—
7300098-1205
LICENSE
UT
01
—
7865804-1206
LICENSE
UT
Enumeration date
06/17/2013
Last updated
06/17/2013
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