| NPI | 1407225188 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID C HEATON Director 435-680-1316 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: UT 8798957-0160) |
| Enumeration Date | 2015-09-23 |
| Last Update Date | 2015-09-23 |