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Contact Information

PURE LIFE PTG
7390 S CREEK RD STE 202
SANDY, UT84093-6123
 Phone: 801-893-2550
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Addiction (Substance Use Disorder)

103TA0400X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for PURE LIFE PTG

NPI Number 1003323767
LBN Legal business name PURE LIFE PTG
Authorized official JOHN LUND - (EXECUTIVE DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 01/03/2018
Last updated 01/03/2018 - About 8 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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