| NPI | 1871637009 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH K BOBERG Owner 801-255-5999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: UT 138930-6006) |
| Enumeration Date | 2007-02-19 |
| Last Update Date | 2020-08-22 |