| NPI | 1932813292 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL GREY WALTER Owner 801-879-1444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-01-11 |
| Last Update Date | 2023-10-23 |