| NPI | 1821309238 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY A JENSON Business Director/Owner 801-687-1357 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2010-06-30 |