| NPI | 1326304023 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLEY MANGUM Ass. Clinical Mental Health Counsel 801-796-0620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: 5828209-6009) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: UT 5828209-6009) |
| Enumeration Date | 2012-04-06 |
| Last Update Date | 2012-06-25 |