Organization
LIVE FOR LIFE CYPRESS
Active
Organization
LIVE FOR LIFE CYPRESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TROY SHAW (EXECUTIVE DIRECTOR)
(801) 577-4142
Entity
Organization
Contact information
Practice address
3023 N BRONZEWOOD CIR, ERDA, UT 84074-3302
(801) 577-4142
Mailing address
3023 N BRONZEWOOD CIR, ERDA, UT 84074-3302
(801) 577-4142
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
9716
UT
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
03/26/2015
Last updated
02/19/2026
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