| NPI | 1316392897 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT MILLER Administrator 801-244-0517 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2016-05-03 |
| Last Update Date | 2016-08-26 |