Healthcare Provider Details

I. General information

NPI: 1447899570
Provider Name (Legal Business Name): FIRST CHOICE HEALING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2020
Last Update Date: 01/06/2020
Certification Date: 01/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1045 S OREM BLVD
OREM UT
84058-6979
US

IV. Provider business mailing address

1063 W 105 N
OREM UT
84057-4464
US

V. Phone/Fax

Practice location:
  • Phone: 435-265-5788
  • Fax:
Mailing address:
  • Phone: 435-265-5788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: TIRZAH ROGERS
Title or Position: CEO
Credential: LCMHC
Phone: 435-265-5788