| NPI | 1083876734 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL C GAEDE Executive Director 801-623-4770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: UT 6332186-0142) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2008-06-25 |