| NPI | 1831313436 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMARA J LOFTHOUSE Board Director 435-201-2074 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: UT 0998) |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2008-08-04 |