| NPI | 1225968902 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON STEVENS Owner 801-609-1516 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2026-05-22 |
| Last Update Date | 2026-05-22 |