| NPI | 1700168374 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON M BURR Clinical Director 435-836-2535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: UT 18393) |
| Enumeration Date | 2011-09-09 |
| Last Update Date | 2011-09-09 |