| NPI | 1285447433 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRICIA HANCOCK Office Manager 435-279-6036 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2025-01-30 |
| Last Update Date | 2025-02-18 |