| NPI | 1699413849 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAN FAZZINI Trustee 801-281-0700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Enumeration Date | 2022-05-26 |
| Last Update Date | 2022-06-02 |