| NPI | 1912233677 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL JOSEPH PETERSON Director 801-907-0462 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: UT 2645) |
| Enumeration Date | 2009-10-29 |
| Last Update Date | 2009-12-01 |