| NPI | 1679956437 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA JEAN MEZA Clinical Director 801-676-9160 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: UT 79799323902) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: UT 79799323902) |
| Enumeration Date | 2015-06-29 |
| Last Update Date | 2015-06-29 |