| NPI | 1780965426 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH MICHAEL TIMMINS Owner 801-572-3750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: UT 961146643501) |
| Enumeration Date | 2011-09-08 |
| Last Update Date | 2011-09-08 |