| NPI | 1780363713 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NEIL PATRICK WARDLE Group Owner 801-680-8751 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2023-07-17 |
| Last Update Date | 2023-07-17 |