Organization
LIFE INCLUDED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TAMARA J LOFTHOUSE (BOARD DIRECTOR)
(435) 201-2074
Entity
Organization
Contact information
Practice address
160 S MAIN ST, RICHFIELD, UT 84701-2557
(435) 201-2074
Mailing address
178 SOUTH MAIN STREET, RICHFIELD, UT 84701
(435) 896-8997
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
0998
UT
Other
Enumeration date
04/13/2007
Last updated
08/04/2008
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