| NPI | 1366574568 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRUDY WIDUP Business Office Manager 435-865-1437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2020-08-22 |