| NPI | 1932231545 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA LANNON Business Office Manager 801-967-7664 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2020-08-22 |