| NPI | 1700303716 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINA DIETZ Owner 801-683-1160 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health (Licence: UT 8020295-6004) |
| Enumeration Date | 2017-08-29 |
| Last Update Date | 2017-08-29 |