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General NPI Number Information
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NPI Number | 1417816794
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Entity Type | Organization
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Legal Business Name | LIFESTYLE MENTAL HEALTH INC
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Dates
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Enumeration Date | 01/21/2026
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Last Update Date | 01/21/2026
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Provider Practice Location Address
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Address Line | 1001 BISHOP ST STE 2685
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City | HONOLULU
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State | HI
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Zip | 96813-3404
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Country | US
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Telephone | 801-477-7189
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Fax | 888-745-9274
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Provider Business Mailing Address
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Address Line | 1221 S VALLEY GROVE WAY STE 160
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City | PLEASANT GROVE
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State | UT
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Zip | 84062-6758
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Country | US
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Telephone | 385-387-1537
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Fax | 888-745-9274
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Authorized Official
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Title or Position | OWNER
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Name | THOMAS RAYNER
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Credential | MD
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Telephone | 385-387-1573
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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