| NPI | 1871335158 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KILEY KIDD Owner 801-855-6420 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-06-10 |
| Last Update Date | 2024-06-10 |