| NPI | 1497490155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREYDEN JOSEF HEDBERG Revenue Cycle Manager 435-319-0351 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2022-04-27 |
| Last Update Date | 2022-04-27 |