| NPI | 1124525175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY VOORHEES Owner Director 435-680-6276 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: UT 20192) |
| Enumeration Date | 2018-04-06 |
| Last Update Date | 2018-04-06 |