| NPI | 1619424454 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERRIE NEBEKER Owner 801-931-9814 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: UT 96404220162) |
| Enumeration Date | 2016-09-09 |
| Last Update Date | 2016-09-09 |