| NPI | 1730460692 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYLE BLACK Rehab Director 435-764-2888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: OK 1073) |
| Enumeration Date | 2011-09-06 |
| Last Update Date | 2011-09-06 |