| NPI | 1023474509 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA J WAGHORNE-SCHULZ President 801-473-3963 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2016-01-13 |
| Last Update Date | 2023-03-17 |