| NPI | 1053779041 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY RANDALL CHRISTENSEN Operations Director 435-773-5857 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: UT 19187) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: UT 19187) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: UT 19187) | |
| 101YM0800X Counselor, Mental Health (Licence: UT 19187) | |
| 101YP2500X Counselor, Professional (Licence: UT 19187) | |
| 103K00000X Behavior Analyst (Licence: UT 19187) | |
| 261QM0850X Clinic/Center, Adult Mental Health (Licence: UT 19187) | |
| Enumeration Date | 2016-02-04 |
| Last Update Date | 2016-02-04 |