| NPI | 1619228327 |
|---|---|
| Doing Business As | MOUNTAIN HOMES YOUTH RANCH |
| Entity Type | Organization |
| Authorized Contact | ISAAC WALLACE Executive Director 435-781-2450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CO 1514781) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: UT 19546) |
| Enumeration Date | 2012-09-21 |
| Last Update Date | 2012-09-21 |