| NPI | 1215642103 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENDRA A BAUM CEO 801-935-8449 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-01-16 |
| Last Update Date | 2023-03-17 |