| NPI | 1336533348 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE LEWIS Owner 801-907-1391 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: UT 6198245-3501) |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2015-03-27 |