| NPI | 1700939477 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PEGGY JEROME Owner 801-568-2898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WP0809X Registered Nurse Psychiatric/Mental Health, Adult (Licence: UT 2788254405) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2020-08-22 |