| NPI | 1174759385 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY C, COVINGTON Insurance Biller 801-466-3838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: TX 822139) |
| Enumeration Date | 2009-06-02 |
| Last Update Date | 2009-06-02 |