| NPI | 1912194499 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE SANICH Owner 801-910-5650 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: UT 13114) |
| Enumeration Date | 2007-09-28 |
| Last Update Date | 2007-09-28 |