| NPI | 1770805681 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALERIE E FAAOOTOA Quality Assurance Director 801-420-4697 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: UT 15163) |
| Enumeration Date | 2010-02-18 |
| Last Update Date | 2010-02-18 |