| NPI | 1316412166 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARALEE CHILD Owner 801-589-4965 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-10-08 |
| Last Update Date | 2018-10-08 |