| NPI | 1164898409 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH K YAU Manager 801-201-4348 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: UT 174377-1205) |
| Enumeration Date | 2015-08-20 |
| Last Update Date | 2015-08-20 |