| 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 |