| NPI | 1033505011 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHANNA SALTER Owner 801-755-4694 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) | |
| 207QA0401X Family Medicine, Addiction Medicine | |
| 323P00000X Psychiatric Residential Treatment Facility | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2015-04-07 |