| NPI | 1760037675 |
|---|---|
| Doing Business As | IPSSE |
| Entity Type | Organization |
| Authorized Contact | JOSEPH R. GOUVEIA-GRANT Clinician 801-520-7938 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2019-08-07 |
| Last Update Date | 2021-07-20 |