| NPI | 1619079779 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENITA J QUAKENBUSH Owner 435-938-6060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility (Licence: UT 11544) |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2022-05-20 |