| NPI | 1407377757 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONI DYCHES CFO 801-803-8240 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2022-07-21 |