| NPI | 1457725764 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE MICHELLE BENSON Medical Director 801-893-2221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2015-11-24 |
| Last Update Date | 2015-11-24 |