| NPI | 1447499140 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN J WONG Clinical Director 801-676-8918 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: UT 14208) |
| Enumeration Date | 2009-02-19 |
| Last Update Date | 2009-02-19 |