| NPI | 1255751558 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH AHQUIN Executive Director 435-229-4889 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: UT 6600) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: UT 6600) |
| 324500000X Substance Abuse Rehabilitation Facility (Licence: UT 6600) | |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: UT 6600) | |
| 251S00000X (Licence: UT 8066) | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: UT 8067) | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: UT 8067) | |
| 323P00000X Psychiatric Residential Treatment Facility (Licence: UT 8066) | |
| 323P00000X Psychiatric Residential Treatment Facility (Licence: UT 8067) | |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: UT 8066) | |
| 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) (Licence: UT 8067) | |
| Enumeration Date | 2014-04-24 |
| Last Update Date | 2014-06-12 |