| NPI | 1780972547 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM GARDINER Clinical Director 801-394-7548 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: UT 263938-3501) |
| Enumeration Date | 2011-07-14 |
| Last Update Date | 2011-07-14 |