| NPI | 1326410960 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY RANDALL CHRISTENSEN Operations Director 435-773-5857 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder (Licence: UT 14091) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: UT 14091) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: UT 14091) | |
| 101YM0800X Counselor Mental Health (Licence: UT 14091) | |
| 101YP2500X Counselor Professional | |
| 103K00000X Behavior Analyst (Licence: UT 14091) | |
| 261QM0850X Clinic/Center Adult Mental Health (Licence: UT 14091) | |
| Enumeration Date | 2015-10-22 |
| Last Update Date | 2015-10-28 |