| NPI | 1780041772 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACI M ROBINSON Owner/Executive Director 801-703-5036 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: UT 79071956004) |
| Enumeration Date | 2016-01-21 |
| Last Update Date | 2016-09-27 |