| NPI | 1841716990 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARA MITCHELL Owner 435-668-4138 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health (Licence: UT 8208838-6004) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: UT 8208838-6004) |
| Enumeration Date | 2017-08-21 |
| Last Update Date | 2018-05-12 |