| NPI | 1407578263 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL COLVER Director 801-717-6238 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| Enumeration Date | 2022-09-16 |
| Last Update Date | 2025-08-07 |