| NPI | 1588292064 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORDAN BURNINGHAM Executive Director 801-330-3440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2024-02-06 |