| NPI | 1740583079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES RUSSELL MARCHEL Agency Administrator 801-969-3307 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: UT 293074-2501) |
| Enumeration Date | 2010-12-08 |
| Last Update Date | 2010-12-08 |