| NPI | 1902209166 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA ADAMSON CHRONISTER Program Director 801-425-0227 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: UT 82874683502) |
| Enumeration Date | 2014-10-02 |
| Last Update Date | 2014-10-02 |