| NPI | 1184029639 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAYE LOPEZ Administrator 801-225-9599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare (Licence: UT 2013-hha-825) |
| Enumeration Date | 2014-10-27 |
| Last Update Date | 2014-10-27 |