| NPI | 1053583435 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH HENRY TABISH Clinical Director 801-463-7520 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 18922) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: UT 134757) |
| 1041C0700X Social Worker, Clinical (Licence: UT 13457) | |
| Enumeration Date | 2008-03-26 |
| Last Update Date | 2012-09-24 |