| NPI | 1205176625 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENESE MCDONALD Clinical Therapist 801-373-6562 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: UT 5883071-6009) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: UT 5883071-6006) |
| Enumeration Date | 2013-02-21 |
| Last Update Date | 2013-02-21 |