| NPI | 1700224193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRAD HOLLEY Co Owner 801-449-0017 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: UT 6062825-0160) |
| Enumeration Date | 2013-06-07 |
| Last Update Date | 2013-06-07 |