NPI | 1487068979 |
---|---|
Entity Type | Organization |
Authorized Contact | TIMOTHY BRYSON JINDRA Mental Health Counselor 801-358-0967 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Additional Taxonomies | 261QD1600X Clinic/Center, Developmental Disabilities |
261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
261QM1100X Clinic/Center, MilitaryU.S. Coast Guard Outpatient | |
261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: UT 7025125-6004) | |
Enumeration Date | 2014-06-12 |
Last Update Date | 2014-06-12 |