| NPI | 1396507695 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID JAMES ALDRICH Owner 435-962-0705 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-01-23 |
| Last Update Date | 2024-10-08 |