NPI | 1316009228 |
---|---|
Other Name | VMH - PHEASANT HOLLOW |
Entity Type | Organization |
Authorized Contact | GARY G LARCENAIRE Chief Executive Officer 801-263-7186 |
Organization Subpart ? | No |
Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities (Licence: UT 12009) |
Enumeration Date | 2006-12-15 |
Last Update Date | 2021-01-21 |