| NPI | 1629792585 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHASE VANCE Owner 801-390-1542 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2022-10-03 |
| Last Update Date | 2022-10-03 |