| NPI | 1174051072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RODNEY ANDRUS Executive Director 801-447-4865 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility (Licence: UT 39298) |
| Enumeration Date | 2017-05-23 |
| Last Update Date | 2017-05-23 |