NPI | 1720425168 |
---|---|
Entity Type | Organization |
Authorized Contact | KYLE STEPHEN GILLETT Executive Director 801-913-8795 |
Organization Subpart ? | No |
Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
Enumeration Date | 2013-05-24 |
Last Update Date | 2013-05-24 |