| NPI | 1053671123 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL K DAHLIN Clinical Director 801-334-5051 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2012-05-23 |
| Last Update Date | 2012-05-23 |