| NPI | 1467717918 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BROOKE HANSEN RN 801-743-1715 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2012-07-11 |