| NPI | 1215068267 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL WIEDERHOLD Executive Director 801-794-0318 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: UT 12040) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2020-08-22 |