| NPI | 1164669081 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA KAY HAFEN Clinical Director 801-373-0210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: UT 271649-3501) |
| Enumeration Date | 2009-01-14 |
| Last Update Date | 2009-01-14 |