| NPI | 1568900116 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARGO L VANE Office Manager 801-798-7700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility (Licence: UT 18290) |
| Enumeration Date | 2017-02-03 |
| Last Update Date | 2017-02-03 |