NPI | 1720317811 |
---|---|
Entity Type | Organization |
Authorized Contact | LARRY E DIXON Owner 435-979-6372 |
Organization Subpart ? | No |
Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: UT 16113) |
Enumeration Date | 2009-12-18 |
Last Update Date | 2009-12-18 |