| NPI | 1295461309 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN BROWN Owner 801-673-7661 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2022-07-29 |
| Last Update Date | 2023-08-21 |