NPI | 1033606298 |
---|---|
Entity Type | Organization |
Authorized Contact | LORNA BURR Owner 801-598-7765 |
Organization Subpart ? | No |
Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
Enumeration Date | 2018-04-13 |
Last Update Date | 2019-09-30 |