| NPI | 1922323203 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM MALAN POLL Clinical Director 435-723-4600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: UT 16063) |
| Enumeration Date | 2010-03-30 |
| Last Update Date | 2010-03-30 |