Healthcare Provider Details

I. General information

NPI: 1326496654
Provider Name (Legal Business Name): STRENGTHENING TEENS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2016
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 N 1330 W STE A1
OREM UT
84057
US

IV. Provider business mailing address

165 N 1330 W STE A1
OREM UT
84057-5116
US

V. Phone/Fax

Practice location:
  • Phone: 801-960-3040
  • Fax:
Mailing address:
  • Phone: 801-960-3040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number87657390160
License Number StateUT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. ERIC SCOTT LANDON
Title or Position: EXECUTIVE DIRECTOR
Credential: CRTS, TRS
Phone: 801-960-3040