| NPI | 1407116072 |
|---|---|
| Doing Business As | INTERMOUNTAIN SUBSTANCE ABUSE |
| Entity Type | Organization |
| Authorized Contact | ERIK OLAFSSON Director 801-268-9844 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: UT 18895) |
| Enumeration Date | 2012-05-16 |
| Last Update Date | 2012-05-16 |