| NPI | 1295266559 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATIE THOMA CFO 801-703-4480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2017-03-27 |