| NPI | 1760026942 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAYNE MILLER CFO 801-330-8845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2019-10-31 |
| Last Update Date | 2019-10-31 |