| NPI | 1255818233 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYNDEL MARCROFT Owner 435-668-0832 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: UT 377874-3501) |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-07-23 |
| Last Update Date | 2023-11-03 |