| NPI | 1073134474 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA CACERES-LOVELESS Executive Clinical Director 801-935-5796 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2020-04-27 |
| Last Update Date | 2020-04-27 |