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LIFELINE FOR YOUTH
NPI 1174711873
Clinic/Center - Rehabilitation, Substance Use Disorder in North Salt Lake, UT

Active since October 09, 2007
1130 W CENTER ST, NORTH SALT LAKE, UT 84054(801) 936-4000 Get Directions Write a Review

NPPES record last updated: October 21, 2011. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Lifeline For Youth NPPES

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

LIFELINE FOR YOUTH (NPI 1174711873) is a healthcare organization registered as a rehabilitation, substance use disorder in North Salt Lake, Utah and active in the NPI registry since October 2007. The organization lists Shane R Petersen, Chief Executive Officer, as its authorized official.

NPPES Registry Identity

NPI1174711873
Entity TypeOrganization
Primary Taxonomy261QR0405X
Legal Business NameLIFE-LINE, INC.
Location Address1130 W CENTER STNorth Salt Lake, UT 84054-2917
Mailing Address1130 W Center StNorth Salt Lake, UT 84054-2917 · (801) 936-4000
Phone(801) 936-4000
Organization SubpartNo
Authorized OfficialShane R PetersenChief Executive Officer · (801) 936-4000
Enumeration DateOctober 9, 2007
Last NPPES UpdateOctober 21, 2011
✔ NPI 1174711873 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Rehabilitation, Substance Use DisorderAmbulatory Health Care Facilities
Taxonomy Code261QR0405X
License✔ Licensed in UT · 11832
Also ListedClinic/Center · Adolescent and Children Mental HealthTaxonomy 261QM0855X · License 11832 (UT)
1130 W CENTER ST, North Salt Lake, UT 84054
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Other Names 1

Doing Business AsLifeline For Youth

Other Providers at the Same Location NPPES 3

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

RALPH WILLIAM KNAPP M.D.
Psychiatry & Neurology (Child & Adolescent Psychiatry)
1130 W CENTER ST
NORTH SALT LAKE, UT 84054
Davis County (801) 936-4000
LIFE-LINE, INC.
Substance Abuse Rehabilitation Facility
1130 W CENTER ST
NORTH SALT LAKE, UT 84054
Davis County (801) 936-4000
LIFELINE BEHAVIORAL HEALTH, LLC
Substance Abuse Rehabilitation Facility (Substance Abuse Treatment, Children)
1130 W CENTER ST
NORTH SALT LAKE, UT 84054
Davis County (801) 936-4000

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-Line, Inc.'s NPI number?

The NPI number for Life-Line, Inc. is 1174711873. It was assigned to this organization in the NPPES registry on October 9, 2007. The provider is doing business as Lifeline For Youth.

Where is Life-Line, Inc. located?

Life-Line, Inc. is located at 1130 W Center St, North Salt Lake, UT 84054. The listed phone number is (801) 936-4000.

What is Life-Line, Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rehabilitation, Substance Use Disorder, with taxonomy code 261QR0405X.

When was this NPI record last updated?

The NPPES record for Life-Line, Inc. was last updated on October 21, 2011. NPI Profile syncs with the weekly NPPES data releases published by CMS.