| NPI | 1548500614 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN PACE Executive Director 435-673-6111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility (Licence: UT 20004) |
| Additional Taxonomies | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: UT 20004) |
| Enumeration Date | 2013-02-26 |
| Last Update Date | 2015-06-24 |