| NPI | 1770379216 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTINA PUGH Owner 801-599-7123 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-04-18 |
| Last Update Date | 2025-04-24 |