| 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 |