| NPI | 1659577476 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL R. ODOM Administrator 801-233-8670 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: UT 12931) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2020-08-22 |