| NPI | 1164857843 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA TULLEY Member, Program Director 801-380-3247 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: UT 6088135-3501) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261QC1500X Clinic/Center, Community Health | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2013-09-12 |
| Last Update Date | 2013-09-12 |