| NPI | 1215209689 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY A MASON Therapist 801-690-3502 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: UT 68222416004) |
| Enumeration Date | 2012-02-01 |
| Last Update Date | 2012-02-01 |