| NPI | 1306199120 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORBIN LINDE Owner 801-798-9077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2012-10-17 |
| Last Update Date | 2012-10-17 |