| NPI | 1386995611 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANETTE THOMPSON Manager 801-290-2706 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: UT 18983) |
| Enumeration Date | 2012-09-26 |
| Last Update Date | 2012-09-26 |