| NPI | 1649408733 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW B CHECKETTS President 801-250-9762 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: UT 14913) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: UT 14912) |
| Enumeration Date | 2009-06-26 |
| Last Update Date | 2009-06-26 |