| NPI | 1225388622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK JORGENSEN CEO 435-817-1351 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: UT 19493) |
| Enumeration Date | 2012-09-12 |
| Last Update Date | 2012-09-12 |