| NPI | 1104238195 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN K FARMER Owner 435-881-1107 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: UT 7551881-3902) |
| Enumeration Date | 2014-05-23 |
| Last Update Date | 2014-05-23 |