| NPI | 1528223195 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAM J COATES Psychiatrist 801-426-8800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: UT 12164) |
| Enumeration Date | 2008-07-23 |
| Last Update Date | 2008-07-23 |