| NPI | 1679184105 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSH WILKEY Owner 435-436-5321 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2020-08-10 |
| Last Update Date | 2020-08-10 |