| NPI | 1568909117 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY PATTON Administative Director 801-856-7836 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: UT 26066) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility (Licence: UT 26065) |
| Enumeration Date | 2017-01-20 |
| Last Update Date | 2017-02-02 |