| NPI | 1598199929 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL THOMAS CALLISTER Owner 801-755-5138 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: UT 7699104-6004) |
| Enumeration Date | 2013-08-21 |
| Last Update Date | 2018-06-19 |