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LIFE INTEGRATIVE HEALTH CENTER
NPI 1063833721
Clinic/Center in Provo, UT

Active since December 26, 2013
777 N 500 W, SUITE 104, PROVO, UT 84601(801) 869-8199(801) 705-0436 Get Directions Write a Review

NPPES record last updated: April 9, 2014. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Life Integrative Health Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LIFE INTEGRATIVE HEALTH CENTER (NPI 1063833721), doing business as Theta Wellness Center - Provo, is a healthcare organization registered as a clinic/center in Provo, Utah and active in the NPI registry since December 2013. The organization lists Kendra Bernal, Clinical Administrator, as its authorized official.

NPPES Registry Identity

NPI1063833721
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameLIFE INTEGRATIVE HEALTH CENTER
Location Address777 N 500 W, SUITE 104Provo, UT 84601-1541
Mailing Address777 N 500 W Ste 104Provo, UT 84601-1541 · (801) 869-8199 · Fax (801) 705-0436
Phone(801) 869-8199
Fax(801) 705-0436
Organization SubpartNo
Authorized OfficialKendra BernalClinical Administrator · (801) 869-8199
Enumeration DateDecember 26, 2013
Last NPPES UpdateApril 9, 2014
✔ NPI 1063833721 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
Also ListedClinic/Center · Health ServiceTaxonomy 261QH0100X · License 0000000 (UT), NOT REQUIRED (UT)
Also ListedClinic/Center · Adult Mental HealthTaxonomy 261QM0850X · License 00000000000 (UT), NOT REQUIRED (UT)
Also ListedClinic/Center · Adolescent and Children Mental HealthTaxonomy 261QM0855X · License NOT REQUIRED (UT)
777 N 500 W, Provo, UT 84601
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Other Names 1

Former Legal Business NameTheta Wellness Center - Provo

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. LOUIS A ERICKSON DDS
Dentist (General Practice)
777 N 500 W, SUITE 201 B
PROVO, UT 84601
Utah County (801) 374-5100
DR. GARY M HULET DMD
Dentist
777 N 500 W, SUITE 101B
PROVO, UT 84601
Utah County (801) 375-1275
DR. WILLIAM LECILE MCBEE DDS
Dentist (Oral and Maxillofacial Surgery)
777 N 500 W, SUITE 102
PROVO, UT 84601
Utah County (801) 375-4707
KYLE KONE LAMFT
Marriage & Family Therapist
777 N 500 W, #104
PROVO, UT 84601
Utah County (801) 869-8199
WISE CHOICE DENTISTRY INC.
Dentist (General Practice)
777 N 500 W, SUITE 201 B
PROVO, UT 84601
Utah County (801) 374-5200
LYNDI JENSON D.D.S
Dentist
777 N 500 W
PROVO, UT 84601
Utah County (801) 455-5244
KELLY A GOMEZ DPM PC
Clinic/Center (Podiatric)
777 N 500 W, SUITE 105
PROVO, UT 84601
Utah County (801) 375-6677
EDISON STANFORD HEARING AID CENTER
Hearing Aid Equipment
777 N 500 W, SUITE 005
PROVO, UT 84601
Utah County (801) 373-5887

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Life Integrative Health Center's NPI number?

The NPI number for Life Integrative Health Center is 1063833721. It was assigned to this organization in the NPPES registry on December 26, 2013. The provider was formerly known as Theta Wellness Center - Provo.

Where is Life Integrative Health Center located?

Life Integrative Health Center is located at 777 N 500 W Suite 104, Provo, UT 84601. The listed phone number is (801) 869-8199.

What is Life Integrative Health Center's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

When was this NPI record last updated?

The NPPES record for Life Integrative Health Center was last updated on April 9, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.