| NPI | 1376772285 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZACHARY CHAMPION Billing Manager 801-282-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: UT 14991) |
| Enumeration Date | 2009-07-13 |
| Last Update Date | 2022-04-19 |