| NPI | 1174117329 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE L. GARDNER Owner 801-876-0036 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-02-26 |
| Last Update Date | 2021-02-26 |