| NPI | 1922579689 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDRAH KEENAN Owner 435-680-2726 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2018-12-06 |
| Last Update Date | 2020-01-29 |