| NPI | 1912411992 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK SPALDING Clinical Director 801-725-7451 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| Enumeration Date | 2017-11-28 |
| Last Update Date | 2019-10-15 |