| NPI | 1316385750 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SERGIO A JIMENEZ Sole Mbr 801-676-9860 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 8631987-0162) |
| Enumeration Date | 2013-06-07 |
| Last Update Date | 2013-08-26 |