Live for Life Cypress
Organization Active NPI Mental Illness Community Based Residential Treatment Facility · Erda, UT
NPI 1922492057 · NPPES record last updated Feb 19, 2026
Key facts
- NPI
- 1922492057
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Illness Community Based Residential Treatment Facility 320800000X
- Legal business name
- LIVE FOR LIFE CYPRESS
- Practice address
- 3023 N Bronzewood Cir
Erda, UT 84074-3302 - Phone
- (801) 577-4142
- NPI assigned
- Mar 26, 2015
- Organization subpart
- No
Authorized official
- Name
- Troy Shaw
- Title
- Executive Director
- Phone
- (801) 577-4142
Practitioners 4
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 46D2161185 | Live for Life Cypress | Certificate of waiver | Jan 28, 2027 |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foster Care Agency | 253J00000X | 9716 | UT | |
| Mental Illness Community Based Residential Treatment Facility | 320800000X | Yes |
Addresses
Primary practice location
3023 N Bronzewood Cir
Erda, UT 84074-3302
Mailing address
3023 N Bronzewood Cir
Erda, UT 84074-3302
Phone (801) 577-4142
Other providers in Erda, UT
- Austin King Fackler
- Allan L Havili
- Atunaisa O Havili
- Melodyann Oberle Jones
- Marsha C Knight
- Edgar J Martinez
- Mike Rady
- Emily Marie Smith
- Lindsay Sundloff
- Kristy Johnson Trujillo
All providers in Erda, UT · Mental Illness Community Based Residential Treatment Facility in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 19, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.