| NPI | 1508265612 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYLER DALLAS Administrator 801-205-9229 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: UT 9362) |
| Enumeration Date | 2014-08-14 |
| Last Update Date | 2014-08-14 |