| NPI | 1174281018 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MALLORY BOWEN Owner/Program Director 801-225-1528 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2021-12-07 |
| Last Update Date | 2021-12-07 |