NPI | 1295092674 |
---|---|
Entity Type | Organization |
Authorized Contact | TRINITY L VERCIMAK Owner 801-419-1269 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: UT 701394-3501) |
Enumeration Date | 2012-04-23 |
Last Update Date | 2012-04-23 |