| NPI | 1306650726 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELLE TUPUA Excutive Director 801-800-1522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| Enumeration Date | 2025-02-05 |
| Last Update Date | 2025-02-05 |