NPI | 1265997746 |
---|---|
Entity Type | Organization |
Authorized Contact | MANDY ERICKSON Clinical Director/ Owner 801-678-4198 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
Enumeration Date | 2019-02-08 |
Last Update Date | 2019-02-08 |