| NPI | 1053157206 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY POOL Owner 435-239-8768 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2024-07-08 |
| Last Update Date | 2024-07-08 |