Organization
LIFESKILLS VOCATIONAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JEANIE PETTIT ADMINISTRATOR CEO (MANAGER)
(801) 554-6992
Entity
Organization
Contact information
Practice address
1656 W 1500 S, SALT LAKE CITY, UT 84104
(801) 977-3732
(801) 977-3751
Mailing address
15173 ROSE CANYON RD, HERRIMAN, UT 84065-4482
(801) 554-6992
(801) 977-3751
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
19967974
UT
Other
Enumeration date
10/25/2005
Last updated
08/22/2020
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