| NPI | 1730555129 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN C CARL Owner 801-839-5594 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: UT 6900557-2501) |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2015-08-19 |