| NPI | 1033744776 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMILY DIANA CAPITO Owner 801-898-0842 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-03-03 |
| Last Update Date | 2020-03-03 |