| NPI | 1114310497 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUANE M CONNER Owner 801-608-4557 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: UT 11014) |
| Enumeration Date | 2015-03-11 |
| Last Update Date | 2015-03-11 |