| NPI | 1598219149 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE S. GILLETT Executive Director 801-913-8795 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2016-08-12 |
| Last Update Date | 2016-08-12 |