| NPI | 1497277750 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICARDO DAVID ROBLES Owner 801-987-0727 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2017-07-07 |
| Last Update Date | 2017-10-11 |