| NPI | 1710538863 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON D COOMBS CEO 801-350-1716 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 251B00000X Case Management |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2019-09-20 |
| Last Update Date | 2019-09-20 |