| NPI | 1790088011 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES RUSSELL MARCHELL Agencey Administrator 801-969-3307 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: UT 293074-3501) |
| Enumeration Date | 2010-12-08 |
| Last Update Date | 2010-12-08 |