| NPI | 1902480320 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DINA HARGRAVE Owner 801-721-3109 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-05-11 |
| Last Update Date | 2021-05-11 |