| NPI | 1124465489 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW JACOBSON Executive Director 801-609-1166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: UT 20835) |
| Enumeration Date | 2013-05-28 |
| Last Update Date | 2013-05-28 |