| 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 |