| NPI | 1235912346 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANYA DORIUS Owner 801-800-4357 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Enumeration Date | 2023-08-14 |
| Last Update Date | 2023-08-14 |