| NPI | 1639565260 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN ROGER BAILEY Director/Owner 435-262-0891 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: UT 15W91838) |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2015-04-10 |