| NPI | 1932646148 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLAN DAVID FALLS Program Director 801-695-1016 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: UT 30655) |
| Enumeration Date | 2017-01-25 |
| Last Update Date | 2017-01-25 |