| NPI | 1912205360 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT JAY THOMAS Owner 801-867-8550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: UT 22-110817-2501) |
| Enumeration Date | 2011-03-09 |
| Last Update Date | 2011-07-01 |