| NPI | 1659188910 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KORY L MEACHAM Owner/Operator 435-979-2580 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-12-11 |
| Last Update Date | 2024-12-11 |