| NPI | 1124181136 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL K. HINDS Owner 435-752-4646 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: UT 48456193902) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2020-08-22 |