| NPI | 1770828873 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIN TIMMONS Executive Director 801-438-3185 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: UT 20020) |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2012-12-01 |
| Last Update Date | 2021-04-05 |