| NPI | 1477946168 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN ZABRISKIE Owner 801-471-7080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: UT 8001124-3902v) |
| Enumeration Date | 2015-03-05 |
| Last Update Date | 2015-03-05 |