| NPI | 1184011397 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE C NELSON President 801-830-2915 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: UT 6854100-6006) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: UT 6854100-6004) |
| Enumeration Date | 2015-04-25 |
| Last Update Date | 2015-05-16 |