| NPI | 1255943569 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMIAH GOLESH Director 801-455-2687 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2020-08-18 |
| Last Update Date | 2023-08-09 |