| NPI | 1083701338 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY WAYNE MUNN Director 435-586-9521 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: UT 1283483501) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: UT 1283483501) |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2020-08-22 |