| NPI | 1194392670 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHELSIE LAURIE DURDEN Owner 801-367-0394 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2021-06-04 |
| Last Update Date | 2021-06-04 |