Provider Demographics
NPI:1255224481
Name:LIMELIGHT DETOX
Entity type:Organization
Organization Name:LIMELIGHT DETOX
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:GERALD
Authorized Official - Last Name:TRANTER
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:801-472-2533
Mailing Address - Street 1:2140 W 13180 S
Mailing Address - Street 2:
Mailing Address - City:RIVERTON
Mailing Address - State:UT
Mailing Address - Zip Code:84065-6216
Mailing Address - Country:US
Mailing Address - Phone:801-472-2533
Mailing Address - Fax:
Practice Address - Street 1:413 W 500 N
Practice Address - Street 2:
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-1567
Practice Address - Country:US
Practice Address - Phone:801-472-2533
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LIMELIGHT PARENT, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-05-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility