| NPI | 1851564165 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY KENNON COOPER Owner 801-636-3816 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: UT 13427) |
| Enumeration Date | 2008-04-08 |
| Last Update Date | 2008-04-08 |