| NPI | 1700345972 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALYCIA E JURGELA CEO 801-678-3317 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 1041C0700X Social Worker Clinical | |
| 2084A0401X Psychiatry & Neurology Addiction Medicine | |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry | |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2019-06-11 |