| NPI | 1710444245 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON PARK Executive Director 801-471-9289 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2019-02-20 |
| Last Update Date | 2019-02-20 |