Healthcare Provider Details

I. General information

NPI: 1982945945
Provider Name (Legal Business Name): TRAINING IN LIFE CHOICES, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2013
Last Update Date: 03/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4862 S 3100 W
ROY UT
84067-9402
US

IV. Provider business mailing address

4862 S 3100 W
ROY UT
84067-9402
US

V. Phone/Fax

Practice location:
  • Phone: 801-628-0587
  • Fax: 801-776-1281
Mailing address:
  • Phone: 801-628-0587
  • Fax: 801-776-1281

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number151362715
License Number StateUT

VIII. Authorized Official

Name: MRS. DEBORAH ELAINE STICKLER
Title or Position: OWNER
Credential:
Phone: 801-628-0587