| NPI | 1457697369 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM THOMAS KUSHNER Substance Abuse Counselor 801-313-7858 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: UT 2743846006) |
| Enumeration Date | 2012-12-20 |
| Last Update Date | 2012-12-20 |