| NPI | 1285021055 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL BAILEY Manager 435-851-6821 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2015-04-20 |
| Last Update Date | 2015-06-19 |