| NPI | 1427565415 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REGAN HAIGHT Owner 801-701-1006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: UT 376041-4405) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: UT 376041-4405) | |
| Enumeration Date | 2017-12-29 |
| Last Update Date | 2019-01-18 |