| NPI | 1558678763 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONIA LINO CASTRO Staff Supervisor 435-851-4659 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: UT 16464) |
| Enumeration Date | 2010-09-09 |
| Last Update Date | 2010-09-09 |