| NPI | 1598971889 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONN W PETERS Owner 435-649-6838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: UT 312303-2501) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2020-08-22 |