| NPI | 1639400989 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT NIELSON Program Director 435-353-4498 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: UT 15264) |
| Additional Taxonomies | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: UT 15263) |
| Enumeration Date | 2010-01-27 |
| Last Update Date | 2010-01-27 |