NPI | 1770960411 |
---|---|
Entity Type | Organization |
Authorized Contact | BRUCE JENKINS Line Staff/Prs Provider 435-445-5200 |
Organization Subpart ? | No |
Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
Enumeration Date | 2015-05-01 |
Last Update Date | 2015-05-01 |