| NPI | 1730843293 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY RANDALL CHRISTENSEN Executive Director 801-994-1849 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YM0800X Counselor Mental Health | |
| 1041C0700X Social Worker Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 133N00000X Nutritionist | |
| 133V00000X Dietitian, Registered | |
| 163W00000X Registered Nurse | |
| 171M00000X Case Manager/Care Coordinator | |
| 261QM1300X Clinic/Center Multi-Specialty | |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| 363LA2100X Nurse Practitioner Acute Care | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2021-10-29 |
| Last Update Date | 2021-10-29 |