| NPI | 1851023667 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN K STUM Owner 435-574-9193 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-06-29 |
| Last Update Date | 2024-04-30 |