| NPI | 1063098101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLEE SANDERS Program Director 801-318-8219 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2021-03-19 |
| Last Update Date | 2021-03-19 |