| NPI | 1194840157 |
|---|---|
| Other Name | PCMC RESEARCH PARK |
| Entity Type | Organization |
| Authorized Contact | CHRISTINE J. JOHNSON Manager, Provider Enrollment 801-442-3156 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2013-12-03 |