| NPI | 1801104054 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT W WINTERS Owner 435-979-1564 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: UT 16464) |
| Enumeration Date | 2010-09-22 |
| Last Update Date | 2010-09-22 |