| NPI | 1164435129 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANK WHITNEY Pharmacy Director 801-763-4160 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: UT 122434-1704) |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2020-08-22 |