| NPI | 1154773158 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM M POSS CFO 801-486-4877 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2016-07-01 |
| Last Update Date | 2024-04-03 |