| NPI | 1699018622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PERRIANN PARKS BEYERS Owner 801-558-7054 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: UT 74078) |
| Enumeration Date | 2013-03-28 |
| Last Update Date | 2020-04-24 |