| NPI | 1780510784 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH MOHANAVILASAM Owner 801-513-3505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2026-06-18 |
| Last Update Date | 2026-06-18 |