| NPI | 1023534013 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JARED MORONI CASEY CEO 801-407-9998 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0800X Clinic/Center Recovery Care (Licence: UT 6019771-3902) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: UT 6019771-3902) |
| Enumeration Date | 2017-08-21 |
| Last Update Date | 2021-06-17 |