| NPI | 1912165614 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGIE EVANS Insurance Billing 801-766-6604 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility (Licence: UT 13312) |
| Enumeration Date | 2008-05-29 |
| Last Update Date | 2008-05-29 |