Healthcare Provider Details

I. General information

NPI: 1215275482
Provider Name (Legal Business Name): HEALTH, LIFE & WELLNESS SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2013
Last Update Date: 09/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2118 E GLAMIS CT
DRAPER UT
84020-5654
US

IV. Provider business mailing address

2118 E GLAMIS CT
DRAPER UT
84020-5654
US

V. Phone/Fax

Practice location:
  • Phone: 385-313-7654
  • Fax:
Mailing address:
  • Phone: 385-313-7654
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number8278898-0151
License Number StateUT

VIII. Authorized Official

Name: MR. SHELBY A ASHLEY
Title or Position: CEO
Credential:
Phone: 385-313-7654