| NPI | 1780967984 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERONICA BARRY Owner 801-608-0061 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: UT 280801-3501) |
| Enumeration Date | 2011-09-23 |
| Last Update Date | 2011-09-24 |