| NPI | 1295164408 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAMILLE CAMPBELL Co Owner 801-263-6367 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: UT 21266) |
| Enumeration Date | 2013-11-07 |
| Last Update Date | 2013-11-07 |