| NPI | 1609254796 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SONJA LEVESQUE CFO 801-334-1327 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QC1500X Clinic/Center Community Health |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2015-07-16 |