| NPI | 1770987844 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON D COOMBS CEO 801-350-1716 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 251S00000X Community/Behavioral Health | |
| 101Y00000X Counselor | |
| Enumeration Date | 2014-10-17 |
| Last Update Date | 2019-12-30 |