| NPI | 1568839504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM MICHAELE PALMER Owner 801-656-8993 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: UT 376369-6004) |
| Enumeration Date | 2015-08-25 |
| Last Update Date | 2015-08-25 |