| NPI | 1407394927 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEE I BISHOP Clinic Manager 801-992-3479 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: UT 35085) |
| Enumeration Date | 2017-02-03 |
| Last Update Date | 2017-02-03 |