| NPI | 1376090910 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAE KEENAN Owner 435-680-1459 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: NV 16330) |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2017-02-01 |