| NPI | 1467081448 |
|---|---|
| Doing Business As | CACHE KETAMINE AND MENTAL HEALTH |
| Doing Business As | UTAH HOME DETOX |
| Entity Type | Organization |
| Authorized Contact | COLBY MARTIN Owner 435-881-0662 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 207P00000X Emergency Medicine |
| 207Q00000X Family Medicine | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2020-04-02 |
| Last Update Date | 2023-02-23 |