| NPI | 1760788285 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA CLARK Executive Director 801-393-3113 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: UT 17491) |
| Enumeration Date | 2011-01-31 |
| Last Update Date | 2011-01-31 |