| NPI | 1356797294 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN PILCHER Billing Manager 801-428-3407 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV NV2015688985) |
| Enumeration Date | 2016-05-10 |
| Last Update Date | 2016-05-10 |