| NPI | 1346765682 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL KEENAN Executive Administrator 435-673-2299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2017-08-08 |
| Last Update Date | 2022-07-21 |