| NPI | 1609146091 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE CALDWELL Office Manager 801-484-9911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility (Licence: UT 11419) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: UT 18701) |
| 1041C0700X Social Worker, Clinical (Licence: UT 18702) | |
| 106H00000X Marriage & Family Therapist (Licence: UT 18702) | |
| 251S00000X Community/Behavioral Health (Licence: UT 18702) | |
| 253J00000X Foster Care Agency (Licence: UT 18700) | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: UT 18701) | |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: UT 18701) | |
| 253J00000X Foster Care Agency (Licence: UT 18702) | |
| Enumeration Date | 2012-01-03 |
| Last Update Date | 2015-04-15 |