NPI | 1326599010 |
---|---|
Entity Type | Organization |
Authorized Contact | CRAIG RUSSELL COO 801-891-6387 |
Organization Subpart ? | No |
Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) (Licence: UT 30390) |
Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: UT 30389) |
Enumeration Date | 2016-10-18 |
Last Update Date | 2018-04-03 |