MEDICARE: NEW LIFE CENTERS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	284300000X	Special Hospital	SHCF-78054	UT

General Provider Information

NPI Number	:	1649470113
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW LIFE CENTERS

Provider Business Mailing Address
First Line	:	1255 E 3900 S STE 300
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84124-1389
Country	:	US
Telephone Number	:	801-281-3353
Fax Number	:	801-281-3373

Provider Business Practice Location Address
First Line	:	1255 E 3900 S STE 300
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84124-1389
Country	:	US
Telephone Number	:	801-281-3353
Fax Number	:	801-281-3373

Authorized Official
Title or Position	:	CEO
Name	:	ALYSON HARDING
Credential	:	MS
Telephone Number	:	801-281-3353

Provider Enumeration Date	:	07/23/2007
Last Update Date	:	07/23/2007

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Directions to “NEW LIFE CENTERS ” Practice Location

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