| NPI | 1194173237 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHELSIE DURDEN Owner 801-367-0394 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2016-05-31 |
| Last Update Date | 2019-08-09 |