| NPI | 1669874947 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE MINER Clinical Manager 801-216-8000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: UT 71980213501) |
| Enumeration Date | 2014-09-18 |
| Last Update Date | 2014-09-18 |