| NPI | 1174965891 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF SCOTT MOORE Lead Counselor 801-941-3334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: UT 8425844-014) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: UT 8425844-014) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: 8425844-014) | |
| 101YP2500X Counselor Professional (Licence: 8425844-014) | |
| Enumeration Date | 2013-07-23 |
| Last Update Date | 2013-07-23 |