NPI | 1750020855 |
---|---|
Entity Type | Organization |
Authorized Contact | MALLORY MARIE BOWEN Owner 801-420-3117 |
Organization Subpart ? | No |
Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
Additional Taxonomies | 251B00000X Case Management |
261QM0850X Clinic/Center, Adult Mental Health | |
261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
Enumeration Date | 2022-05-27 |
Last Update Date | 2022-05-27 |