| NPI | 1598165920 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREG WARDEN Executive Director 435-216-7369 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: UT 137026-3501) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: UT 137026-3501) |
| 1041C0700X Social Worker, Clinical (Licence: UT 137026-3501) | |
| Enumeration Date | 2014-09-04 |
| Last Update Date | 2014-09-04 |