| NPI | 1114371580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH CHRISTENSEN Director 801-816-1801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: UT 135945-3501) |
| Enumeration Date | 2016-04-21 |
| Last Update Date | 2016-04-21 |