| NPI | 1427445980 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKE JORGENSEN Manager/Member 801-465-5111 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: UT 11006) |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2016-09-20 |