| NPI | 1861945578 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA MEEKINS Owner 801-609-4348 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: UT 73588683501) |
| Enumeration Date | 2016-07-28 |
| Last Update Date | 2016-07-28 |