| NPI | 1114291614 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA D ADAMSON Executive Clinical Director 801-510-9081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: UT 67811516004) |
| Enumeration Date | 2012-02-29 |
| Last Update Date | 2012-02-29 |