| NPI | 1770721300 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAREY TEUILA OFAHENGAUE Compliance Manager 801-602-4039 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: UT 13745) |
| Enumeration Date | 2009-02-04 |
| Last Update Date | 2009-02-04 |