| NPI | 1326767294 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ELLEN COX CFO 435-669-6144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Enumeration Date | 2022-08-24 |
| Last Update Date | 2022-08-24 |