| NPI | 1316497514 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE MICHELLE BENSON Owner/Provider 801-893-2221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: UT 348263-4405) |
| Enumeration Date | 2016-10-11 |
| Last Update Date | 2016-10-11 |