| NPI | 1326933821 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA HALL Owner 435-219-9967 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-06-12 |
| Last Update Date | 2025-08-29 |