| NPI | 1831535954 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA LYNN FERGUSON Owner/Evaluator 801-867-0462 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: UT 50274386004) |
| Enumeration Date | 2013-05-15 |
| Last Update Date | 2019-01-17 |