| NPI | 1649055229 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEGAN MANNING Owner 801-668-4116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-08-30 |
| Last Update Date | 2023-08-30 |