NPI | 1164542379 |
---|---|
Entity Type | Organization |
Authorized Contact | KENNETH E EKONG Executive Director 801-360-6357 |
Organization Subpart ? | No |
Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: UT 2004-20754) |
Enumeration Date | 2007-03-30 |
Last Update Date | 2020-08-22 |