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NPI Code Detail

MEDICARE: PEACEFUL HEART THERAPY

MEDICARE: PEACEFUL HEART THERAPY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor7045961-3501UT

General Provider Information

NPI Number : 1568811883
Entity Type Code : Organization
Provider Name (Legal Business Name) : PEACEFUL HEART THERAPY
Provider Business Mailing Address
First Line : 2319 S FOOTHILL DR STE 180
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84109-5403
Country : US
Telephone Number : 801-809-7985
Fax Number :
Provider Business Practice Location Address
First Line : 2319 S FOOTHILL DR STE 180
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84109-5403
Country : US
Telephone Number : 801-809-7985
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : MS. JILL ELIZABETH ALGER-JAMES
Credential : LCSW
Telephone Number : 801-809-7985
Provider Enumeration Date : 06/07/2016
Last Update Date : 06/07/2016

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Directions to “PEACEFUL HEART THERAPY ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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