| NPI | 1376550566 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN MCMILLEN Executive Director 801-359-8862 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2021-02-04 |