NPI | 1194189233 |
---|---|
Entity Type | Organization |
Authorized Contact | CRYSTAL CONTRERAS Billing 801-359-2256 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: UT 9453799-8906) |
Enumeration Date | 2016-04-05 |
Last Update Date | 2017-12-26 |