| NPI | 1881021301 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY KAY LEHTO Manager 801-647-0752 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: UT 134639-3501) |
| Enumeration Date | 2013-09-29 |
| Last Update Date | 2013-09-29 |