| NPI | 1871570374 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY M. KELSO President 801-389-1523 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities (Licence: UT 2004-ncf-470) |
| Enumeration Date | 2005-12-27 |
| Last Update Date | 2020-08-22 |