| NPI | 1558876961 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY RANDALL CHRISTENSEN Executive Director 801-994-1849 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: UT 51329) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: UT 51329) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: UT 51329) | |
| 101YM0800X Counselor, Mental Health (Licence: UT 51329) | |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: UT 51329) | |
| 103TC1900X Psychologist, Counseling (Licence: UT 51329) | |
| 1041C0700X Social Worker, Clinical (Licence: UT 51329) | |
| 261QM0850X Clinic/Center, Adult Mental Health (Licence: UT 51329) | |
| 106H00000X Marriage & Family Therapist (Licence: UT 51329) | |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: UT 51329) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: UT 51329) | |
| 363A00000X Physician Assistant (Licence: UT 51329) | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: UT 51329) | |
| 225800000X Recreation Therapist (Licence: UT 51329) | |
| 225C00000X Rehabilitation Counselor (Licence: UT 51329) | |
| Enumeration Date | 2017-12-07 |
| Last Update Date | 2020-05-08 |