| NPI | 1013149251 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROD JEPPSEN Program Director 801-598-3332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: UT 14726) |
| Enumeration Date | 2009-08-21 |
| Last Update Date | 2009-08-21 |