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General NPI Number Information
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NPI Number | 1457297608
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Entity Type | Organization
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Legal Business Name | GOOD VIBEZ WELLNESS CENTER LLC
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Dates
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Enumeration Date | 04/28/2026
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Last Update Date | 04/28/2026
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Provider Practice Location Address
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Address Line | 2150 S 1300 E STE 500
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City | SALT LAKE CITY
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State | UT
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Zip | 84106-4375
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Country | US
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Telephone | 801-421-2514
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Fax | 801-613-5226
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Provider Business Mailing Address
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Address Line | 2150 S 1300 E STE 500
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City | SALT LAKE CITY
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State | UT
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Zip | 84106-4375
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Country | US
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Telephone | 801-421-2514
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Fax | 801-613-5226
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Authorized Official
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Title or Position | OWNER
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Name | DESTINY GARCIA
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Credential | APRN
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Telephone | 385-900-9835
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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