| NPI | 1932493681 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKE O'REILLY Program Director 801-691-0672 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: UT 18013) |
| Enumeration Date | 2011-05-29 |
| Last Update Date | 2011-05-29 |