| NPI | 1023414182 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM MICHAEL AHQUIN Executive Director/Owner 435-669-6669 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility (Licence: UT 8035) |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: UT 8035) | |
| Enumeration Date | 2014-11-17 |
| Last Update Date | 2020-08-19 |