| NPI | 1164656815 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAWNY J DAVIS Executive Director 435-890-9180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: UT 12809) |
| Enumeration Date | 2009-05-11 |
| Last Update Date | 2009-05-11 |