| NPI | 1578917787 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICA PETERSON Administrator/Director Of Nursing 801-810-1119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2016-04-14 |
| Last Update Date | 2019-12-13 |