| NPI | 1326710419 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | BRENT D HOFHINES Owner 435-229-3245 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health | 
| Enumeration Date | 2021-09-28 | 
| Last Update Date | 2021-09-28 |