| NPI | 1790195162 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAM JEAN GRAMSE Director 801-392-8900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: UT 3782) |
| Enumeration Date | 2014-05-06 |
| Last Update Date | 2014-05-06 |