| NPI | 1770896680 |
|---|---|
| Doing Business As | PROVO CANYON RESIDENTIAL SERVICES OF UTAH |
| Entity Type | Organization |
| Authorized Contact | SHERI ANN CORONA Director Cbo 801-223-7117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility (Licence: UT 16006) |
| Enumeration Date | 2010-07-20 |
| Last Update Date | 2010-07-20 |