| NPI | 1598118747 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICAH WOODWORTH Administrator 801-669-3967 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2016-07-22 |
| Last Update Date | 2016-07-22 |