| NPI | 1265941702 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA GLEAVE RN/Don 801-830-8541 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: UT 6147456-1204) |
| Enumeration Date | 2017-09-27 |
| Last Update Date | 2022-07-21 |