NPI | 1215123567 |
---|---|
Entity Type | Organization |
Authorized Contact | SHAWN BROOKS Administrator 801-491-2270 |
Organization Subpart ? | No |
Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
Enumeration Date | 2007-09-20 |
Last Update Date | 2024-08-02 |