| NPI | 1720770704 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUNO FERREIRA SILVA Owner 801-503-9009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-05-25 |
| Last Update Date | 2023-05-25 |