| NPI | 1902202260 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMMA MANSOUR Owner 801-232-1161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: UT 8781073-2504) |
| Enumeration Date | 2014-11-14 |
| Last Update Date | 2025-06-05 |