| NPI | 1063276376 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELENA LEDFORD Director, Practice Operations 801-628-7147 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-02-07 |
| Last Update Date | 2024-02-07 |