Lifeline Behavioral Health, LLC
NPI 1780884742 · Children's Substance Abuse Rehabilitation Facility · North Salt Lake, UT
Provider details
- NPI number
- 1780884742
- Entity type
- Organization
- Primary specialty
- Children's Substance Abuse Rehabilitation FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Shane Petersen, Chief Executive Officer(801) 936-4000
Specialties & taxonomies
Residential Treatment Facilities
Residential Treatment Facilities
Ambulatory Health Care Facilities
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Lifeline for Youth
Registry dates
- Enumerated
- 2007-07-18
- Last updated
- 2015-04-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.