| NPI | 1902236458 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATE GREEN Director Of Operations 435-228-4181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: UT 2903) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: UT 2903) |
| Enumeration Date | 2013-11-20 |
| Last Update Date | 2016-05-10 |