| NPI | 1174807259 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA RULLER Office Assistant 801-428-3402 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2011-10-06 |
| Last Update Date | 2011-10-06 |