| NPI | 1669762506 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEWIS E. GALWAY Executive Director 801-915-1290 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: UT 17766) |
| Enumeration Date | 2011-04-12 |
| Last Update Date | 2011-04-12 |